State Health Insurance Information, Counseling, and Assistance Services

The Missouri Department of Commerce and Insurance is requesting proposals for State Health Insurance Information, Counseling, and Assistance Services under RFP STATE 0000000530SL, with proposals due October 5, 2026 by 2:00 PM Central Time and submitted electronically through MissouriBUYS. No set-asides or preference programs apply; all qualified vendors are eligible.

The scope encompasses comprehensive Medicare and health insurance counseling delivered statewide through the Missouri State Health Insurance Program (SHIP), covering enrollment, preventive services, Medigap options, Medicare Advantage plans, Part D prescription drug coverage, appeals, and public benefit programs. The contractor must establish a statewide supervisory structure with a single central point of contact, recruit and train a minimum of 200 certified counseling volunteers distributed across Missouri's geographic regions (including rural counties spanning all 115 counties plus St. Louis City), and partner with community-based programs to ensure service availability to all Medicare beneficiaries. Performance measures include 49,963 counseling contacts (in-person, telephone, and electronic), 91,382 outreach contacts through presentations and fairs, 7,536 contacts with disabled and under-65 Medicare beneficiaries, 63,611 contacts with hard-to-reach populations (low-income, rural, non-native English speakers over 65), and 36,372 unduplicated enrollment contacts for Medicare and Medicaid-related topics. Evaluation will use a five-point Likert scale with acceptable performance standards set at "Average," "Good," or "Excellent" levels.

The contract value totals $1.92 million through March 31, 2027, funded through SHIP grant funds of $1.064861 million (April 1, 2026 through March 31, 2027), state appropriations of $200,000 (fiscal year 2027), MIPPA grant funds up to $457,786 (September 1, 2025 through August 31, 2026), and Benefit Enrollment Centers grant funds up to $200,000 (February 1, 2026 through July 31, 2028). Pricing shall be firm and fixed with monthly invoicing for SHIP and MIPPA services and actual expenses for BEC grant services. The Division of Purchasing reserves renewal options for nine additional one-year periods at the same pricing unless funds are adjusted by state appropriation or federal grant.

The contractor must meet minimum experience requirements of five years with the Administration for Community Living (ACL) and five years providing community outreach services regarding Medicare options. The contractor assumes Business Associate obligations under HIPAA, requiring implementation of administrative, physical, and technical safeguards for Protected Health Information, incident reporting within five calendar days, and six-year documentation retention. Federal compliance obligations include OMB 2 CFR Part 200, the Byrd Anti-Lobbying Amendment, the Drug-Free Workplace Act, the Pro-Children Act, Title VI and VII nondiscrimination requirements, the Americans with Disabilities Act, and the Age Discrimination Act. The current contract is CS171154001.