Nebraska Medicaid Enrollment Broker

The State of Nebraska Department of Health and Human Services is requesting proposals for a Nebraska Medicaid Enrollment Broker service contract via RFP 125920 O3, with proposals due September 30, 2026, at 2:00 PM Central Time. A mandatory solicitation conference is scheduled for September 22, 2026, at 2:00 PM Central Time via Cisco Webex, and written questions are due September 16, 2026.

The scope encompasses enrollment broker services for Nebraska's Medicaid Managed Care Program (Heritage Health), serving eligible elderly and disabled individuals, low-income pregnant women, children, CHIP participants, and home and community-based services waiver recipients. The vendor must deliver choice counseling, member enrollment processing, managed care organization auto-assignment and disenrollment, provider directory maintenance, call center operations, member and provider education, data reporting, and program integrity functions. The system must comply with CMS Medicaid certification outcomes (42 CFR 438 and related standards) and maintain 99% web portal uptime (24/7 except approved maintenance), achieve call center speed-to-answer not to exceed 30 seconds and hold time not to exceed 2 minutes, and process provider file and enrollment database updates by 7:00 AM CST the next business day. A $500,000 performance bond is required.

The initial contract term is five years commencing October 1, 2027, with an option to renew for one additional three-year period upon mutual agreement. The State reserves the right to contract with other sources for the same or similar services and may use this solicitation to procure services for up to eighteen months from the intent-to-award date if additional vendors are needed. The contract is subject to funding availability and incorporates nonnegotiable State of Nebraska standard terms and conditions, including HIPAA Business Associate requirements and compliance with federal executive orders 14151 and 14173.

Responsive proposals must include a Corporate Overview (25 points), Technical Response (55 points), completed Cost Sheet with per-member-per-month pricing across five-year base plus optional renewal years and member volume tiers, completed Solicitation Sections II through IV, and a manually signed or DocuSign-executed Contractual Agreement Form. Cost is worth 20 points using a comparative formula: lowest realistic cost receives maximum 20 points, others scored as (Lowest Cost Submitted ÷ Cost Submitted) × 20. Vendor demonstrations may earn an optional 20 additional points for a possible total of 120 points. Intent to Award is scheduled for October 20, 2026, with contract finalization between November 4–12, 2026, and contract award on November 13, 2026. All bidders must be registered with the Nebraska Secretary of State and submit electronically via ShareFile.