Enrollment Broker

The Texas Health and Human Services Commission (HHSC) is requesting proposals for Enrollment Broker Operations services under RFP No. HHS0016867, with proposals due September 4, 2026, and a pre-proposal conference on July 21, 2026. This is a sole-source procurement for a single qualified contractor. A VetHUB participation goal of 26% applies to subcontracting opportunities; respondents must demonstrate good-faith effort to include certified VetHUB vendors or attest to self-performance.

The scope encompasses enrollment processing, document management, call center operations, outreach and informing services, interest list management for Home and Community Based Services, and cost-sharing and premium collection across eight managed care programs: STAR, STAR+PLUS, STAR Health, STAR Kids, Children's Medicaid Dental Services, CHIP, CHIP Perinatal, and CHIP Dental. The contractor must achieve Texas Risk and Authorization Management (TX-RAMP) Level 2 Certification by contract effective date and maintain comprehensive compliance with NIST SP 800-53 Revision 5 security controls, HIPAA requirements, and detailed information security and privacy standards. Minimum qualifications require three years of experience providing enrollment services in a healthcare setting within the past ten years and demonstrated financial solvency.

Historical compensation has ranged from approximately $75 million to $82 million per State Fiscal Year; HHSC reserves the right to adjust projected amounts based on state funding availability and makes no guarantee of volume, usage, or total compensation. The initial contract term is four years with options for HHSC to extend up to four additional years, followed by a potential one-year extension. The incumbent contractor operates from 3501 Ed Bluestein Boulevard, Austin, Texas 78721.

Evaluation employs best value determination: Project Work Plan (30 points), Technical Proposal (30 points), Qualifications and Demonstrated Relevant Experience (20 points), Cost Approach (10 points), and Total Cost (10 points). Oral presentations addressing Enrollment Services, Call Center Operations, and THSteps Outreach scenarios are anticipated in November 2026. The anticipated notice of award is August 2027, with contract start date September 2027. Questions are due July 24, 2026; responses post by August 14, 2026. The contractor must maintain workers' compensation, commercial general liability ($2 million per occurrence / $4 million aggregate), comprehensive automobile liability ($1 million combined single limit), cyber/privacy liability ($10 million), professional liability ($10 million), umbrella liability ($10 million), and crime insurance ($5 million).