Nebraska Medicaid Enrollment Broker

Nebraska's Department of Health and Human Services, through the State Purchasing Bureau, is soliciting bids for a Medicaid Enrollment Broker for the Heritage Health managed care program under Solicitation 125920 O3. The electronic opening, revised to October 21, 2026, has passed, and the Intent to Award is scheduled for November 6, 2026. No set-aside applies. Resident disabled veterans and businesses in designated enterprise zones may receive preference only if all other factors are equal, and only with documentation submitted within ten business days of request.

The enrollment broker assigns Medicaid members to managed care organizations under a passive enrollment model with a 90-day switch window. Required performance standards include auto-assignment within 4-6 hours of receiving eligibility records, real-time provider directory updates, a 30-second speed-to-answer call center standard, and 99% web portal availability. The awardee must also deliver ad hoc reports within five business days, monthly reports by the 15th, and 17 implementation work products. Integration runs through daily and monthly SFTP file exchanges with the state's MMIS. Mandatory submissions are a corporate overview, technical response, completed cost sheet, Sections II through IV, and a signed contractual agreement form. The current broker is Automated Health Systems (AHS).

Pricing is per member per month against a planned volume of 350,000 members, and implementation is paid at a fixed price from the cost proposal's implementation tab. The source names no total contract value. Addendum Five confirms eight option years, and a $500,000 performance bond must remain in force for the life of the contract. Penalties are assessed per occurrence, including daily amounts of $500 to $5,000 and $2,500 per percentage point of web portal availability below 99%.

Evaluation totals 100 points: Corporate Overview 25, Technical Response 55, and Cost 20. Vendor demonstrations, if required, add up to 20 points. Cost points go to the lowest realistic bid at the maximum 20, with other bids scored proportionally.

Contract finalization runs through November 23, 2026, with award scheduled for November 26, 2026, and the contract start is October 1, 2027. Go-live runs October 1 through November 1, 2027, and open enrollment runs November 1 through December 15, 2027.