Sole Source / Actuarial Analysis & Consulting

The Illinois Department of Healthcare and Family Services (HFS) intends to award a sole source contract to Milliman, Inc. for actuarial analysis and consulting services. The contract will support the development of actuarially sound capitation rates for various managed care programs, including HealthChoice Illinois, YouthCare, Program of All-Inclusive Care for the Elderly (PACE), Medicaid-Medicare Alignment Initiative (MMAI), and the upcoming Dual Eligible Special Needs Plan (D-SNP) program. The procurement is critical for meeting federal Centers for Medicare & Medicaid Services (CMS) requirements for actuarial certification of managed care capitation rates. The contract is scheduled to begin February 25, 2026, and end August 24, 2027, with no potential renewals. Key deliverables include comprehensive actuarial analysis and consulting services, with an anticipated 72,000 hours of work required. Interested parties must submit written comments or request a public hearing by Monday, October 20, 2025, by 4 p.m. to the designated contact. The procurement process requires deep knowledge of HFS's managed care environment and compliance with federal regulatory standards.

The sole source justification is based on Milliman's existing expertise and previous competitive selection through an RFP process. No specific set-aside designations or restrictions on responding organizations are mentioned in the documentation. Milliman is considered the most responsive and responsible vendor for continuing these critical actuarial services, with the current hourly rate set at $258.70 (including a 2.4% CPI-U increase). The contract's total estimated value is $18,626,400, with funding sourced from both State Appropriate Funds and Federal Funds. The agency argues that transitioning to a new vendor would require approximately six months of onboarding, potentially risking compliance with federal regulations and jeopardizing approximately $15 billion in annual federal matching funds. No incumbent vendor information beyond Milliman is provided, and there are no specific mentions of existing infrastructure or technology integration requirements. The procurement is focused on maintaining continuity of actuarial consulting services for Illinois's managed care programs.