md health benefit exchange ivandv rfp final~1(1)

8/12/2019 MD Health Benefit Exchange IVandV RFP final~1(1)

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Request for Proposals (RFP)

Maryland Health Benefit Exchange: IndependentVerification and Validation

Maryland Health Benefit Exchange (Exchange)

SOLICITATION NO. EXCHANGE (MDM0031004096)

Issue Date: July 27, 2012

Minority Business Enterprises are Encouraged to Respond to this Solicitation

NOTICE

Prospective Offerors who have received this document from the Exchanges web site or eMarylandMarketplace.com, or whohave received this document from a source other than the Procurement Officer, and who wish to assure receipt of any changes

or additional materials related to this RFP, should immediately contact the Procurement Officer and provide their name andmailing address so that addenda to the RFP or other communications can be sent to them.


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STATE OF MARYLANDNOTICE TO OFFERORS/OFFERORS

In order to help us improve the quality of State solicitations, and to make our procurement process mresponsive and business friendly, we ask that you take a few minutes and provide comments ansuggestions regarding the enclosed solicitation. Please return your comments with your proposals. If yhave chosen not to respond on this Contract, please fax this completed form to: (410) 318-8532 to tattention of Rebecca Pearce, Procurement Officer.

Title: Maryland Health Benefit Exchange: Independent Verification and ValidationSolicitation No: MDM0031004096

1. If you have responded with a "no response", please indicate the reason(s) below:

( ) Other commitments preclude our participation at this time.( ) The subject of the solicitation is not something we ordinarily provide.( ) We are inexperienced in the work/commodities required.( ) Specifications are unclear, too restrictive, etc. (Explain in REMARKS section.)( ) The scope of work is beyond our present capacity.( ) Doing business with Maryland Government is simply too complicated. (Explain in REMAR

section.)( ) We cannot be competitive. (Explain in REMARKS section.)( ) Time allotted for completion of the bid/proposals is insufficient.( ) Start-up time is insufficient.( ) Bonding/Insurance requirements are restrictive. (Explain in REMARKS section.)( ) Bid/Proposals requirements (other than specifications) are unreasonable or too risky.

(Explain in REMARKS section.)( ) MBE requirements. (Explain in REMARKS section.)( ) Prior State of Maryland Contract experience was unprofitable or otherwise unsatisfactory. (Expla

in REMARKS section.)( ) Payment schedule too slow.( ) Other:_________________________________________________________________

2. If you wish to offer suggestions or express concerns, please use the Remarks section below. (Use reverseor attach additional pages as needed.)

REMARKS: _________________________________________________________________________

________________________________________________________________________

Offeror Name: ____________________________________ Date:_______________________

Contact Person: _________________________________Phone (____) _____ - _________________Email: ______________________________ Address:_____________________________________________________________


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STATE OF MARYLANDHEALTH BENEFIT EXCHANGE

KEY INFORMATION SUMMARY SHEET

Proposal Name: Maryland Health Benefit Exchange: IndependentVerification and Validation

Solicitation Number: Exchange ( MDM0031004096 )

Issue Date: July 27, 2012

RFP Issuing Office: Maryland Health Benefit Exchange

Procurement Officer: Rebecca PearceOffice Phone: (410) 358-5615Fax: (410) 318-8532e-mail: [email protected]

Contract Monitor: Kevin YangOffice Phone: (410) 358-5615Fax: (410 ) 318-8532e-mail: [email protected]

Proposals are to be sent to: Maryland Health Benefit Exchange4201 Patterson Ave, 4th FloorBaltimore, Maryland 21215Attention: Rebecca Pearce, Procurement Officer

Pre-Proposal Conference: August 3, 2012 9:00 am Local Time1450 South Rolling RoadBaltimore, MD 21227

Closing Date and Time: August 17, 2012 3:00 pm Local Time

MBE Subcontracting Goal: 30 %


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TABLE OF CONTENTS

SECTION 1 GENERAL INFORMATION ...................................................................... 7

1.1 SUMMARY STATEMENT ......................................................................................................................... 1.1.1 Overview ..................................................................................................................................

1.1.2 Scope of Work ......................................................................................................................... 1.1.3 Phases of the HIX Implementation ........................................................................................... 1.2 HIGH-LEVELOVERVIEW OFHIX REQUIREMENTS ...................................................................................... 1 1.2 ABBREVIATIONS ANDDEFINITIONS ......................................................................................................... 1.3 CONTRACTTYPE ................................................................................................................................ 1.4 CONTRACTDURATION .......................................................................................................................... 1.5 PROCUREMENTOFFICER ...................................................................................................................... 1.6 CONTRACTMONITOR ........................................................................................................................... 1.7 PRE-PROPOSALCONFERENCE ............................................................................................................... 1.8 EM ARYLANDM ARKETPLACE................................................................................................................... 1.9 QUESTIONS ........................................................................................................................................

1.10 PROPOSALSDUE- D ATE ANDTIME ........................................................................................................ 1.11 DURATION OFOFFER ........................................................................................................................... 1.12 REVISIONS TO THERFP ....................................................................................................................... 1.13 C ANCELLATIONS& DISCUSSIONS ........................................................................................................... 1.14 ORALPRESENTATION ........................................................................................................................... 1.15 INCURREDEXPENSES............................................................................................................................ 1.16 ECONOMY OFPREPARATION .................................................................................................................. 1.17 PROTESTS ......................................................................................................................................... 1.18 DISPUTES .......................................................................................................................................... 1.19 MULTIPLE OR ALTERNATEPROPOSALS ................................................................................................... 1.20 PUBLICINFORMATION ACTNOTICE .........................................................................................................

1.21 OFFERORRESPONSIBILITIES ................................................................................................................. 1.22 STANDARDCONTRACT ......................................................................................................................... 1.23 PROPOSAL AFFIDAVIT .......................................................................................................................... 1.24 CONTRACT AFFIDAVIT .......................................................................................................................... 1.25 MINORITYBUSINESSENTERPRISES ........................................................................................................ 1.26 ARREARAGES ..................................................................................................................................... 1.27 PROCUREMENTMETHOD ...................................................................................................................... 1.28 VERIFICATION OFREGISTRATION ANDT AXP AYMENT ............................................................................... 2 1.29 P AYMENTS BYELECTRONICFUNDSTRANSFER ........................................................................................ 2 1.30 LIVINGW AGEREQUIREMENTS ............................................................................................................... 1.31 PROMPTP AYMENTPOLICY ...................................................................................................................

1.32 FEDERALFUNDING ACKNOWLEDGEMENT ANDCERTIFICATIONS ................................................................ 29 1.33 CONFLICT OFINTEREST AFFIDAVIT ANDDISCLOSURE ............................................................................... 2 1.34 RETAINAGE ........................................................................................................................................ 1.35 COTS SOFTWARE .............................................................................................................................. 1.36 WITHDRAWALS ................................................................................................................................... 1.37 SUBSTITUTION OFPERSONNEL ............................................................................................................... 1.38 T AXEXEMPTIONS ................................................................................................................................ 1.39 COMPLIANCE WITHFEDERALHIPAA ANDSTATECONFIDENTIALITYL AW ................................................... 30


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SECTION 2 SCOPE OF WORK ................................................................................. 32

2.1 OVERVIEW OFHIX IV&V WORKEFFORT ................................................................................................ 2.2 GENERALIV&V ASSESSMENTGOALS .................................................................................................... 2.3 GENERAL APPROACH FORIV&V ACTVITIES ............................................................................................ 2.4 IV&V STANDARDS ............................................................................................................................... 2.5 DETAILEDT ASKS ................................................................................................................................ 2.6 WORKPRODUCTS................................................................................................................................ 2.7 IV&V REPORTFORMAT ANDCONTENTREQUIREMENTS........................................................................... 4 2.8 STAFFINGPLAN .................................................................................................................................. 2.9 HIX STANDARDS..................................................................................................................................

2.9.1 Physical Security .................................................................................................................... 5 2.9.2 Criminal Background Check................................................................................................... 5

2.10 MBE REPORTS .................................................................................................................................. 2.11 INVOICING ANDP AYMENTTYPE ..............................................................................................................

2.11.1 Invoice Requirements ........................................................................................................ 5 2.11.2 Payment Schedule ............................................................................................................ 54

2.12 INSURANCEREQUIREMENT ................................................................................................................... SECTION 3 PROPOSAL FORMAT ........................................................................... 56

3.1 TWOP ARTSUBMISSION ....................................................................................................................... 3.2 PROPOSALS ....................................................................................................................................... 3.3 DELIVERY .......................................................................................................................................... 3.4 VOLUMEI TECHNICALPROPOSAL ........................................................................................................

3.4.1 Format of Technical Proposal ................................................................................................ 5 3.5 VOLUMEII - FINANCIALPROPOSAL .........................................................................................................

SECTION 4 EVALUATION CRITERIA AND SELECTION PROCEDURE ................ 63

4.1 EVALUATIONCRITERIA ......................................................................................................................... 4.1.1 Technical Criteria ................................................................................................................... 6 4.1.2 Financial Criteria .................................................................................................................... 6

4.2 EVALUATIONPROCESS ......................................................................................................................... 4.2.1 In General .............................................................................................................................. 6 4.2.2 Selection Process Sequence ................................................................................................. 64 4.2.3 Award Determination ............................................................................................................. 6

SECTION 5 ATTACHMENTS .................................................................................... 65

ATTACHMENT A STANDARDCONTRACT ....................................................................................................... ATTACHMENT B BID/PROPOSAL AFFIDAVIT .................................................................................................. ATTACHMENT C CONTRACT AFFIDAVIT ........................................................................................................ ATTACHMENT D - MINORITYBUSINESSENTERPRISEGOAL ANDFORMS ............................................................ 91 ATTACHMENT E PRE-PROPOSALCONFERENCERESPONSEFORM ............................................................... 101 ATTACHMENT F LIVINGW AGEREQUIREMENTS FORSERVICECONTRACTS ................................................... 102 ATTACHMENT G-1 M ARYLANDLIVINGW AGE AFFIDAVIT OF AGREEMENT ...................................................... 104 ATTACHMENT H FEDERALFUNDSREQUIREMENTS ANDCERTIFICATIONS ...................................................... 106 ATTACHMENT I CONFLICT OFINTEREST AFFIDAVIT ANDDISCLOSURE ........................................................... 113 ATTACHMENT J BUSINESS ASSOCIATE AGREEMENT ................................................................................... 11 ATTACHMENT J-1 BREACH OFUNSECUREDPROTECTEDHEALTHINFORMATION ........................................... 121


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ATTACHMENT K NON-DISCLOSURE AGREEMENT(AWARD) .......................................................................... 12 ATTACHMENT L HIX PROJECTPHASES FOR1 A .......................................................................................... 1 ATTACHMENT M HOSTING(OPTIONAL) ...................................................................................................... 1 ATTACHMENT N OPERATIONS(OPTIONAL) ................................................................................................. 1 ATTACHMENT O BUSINESSREQUIREMENTSDOCUMENT ............................................................................. 18

ATTACHMENT P DETAILEDTECHNICALREQUIREMENTS .............................................................................. 29 ATTACHMENT Q IV&V REPORTS FOREXCHANGECERTIFICATION ............................................................... 324 ATTACHMENT R PERFORMANCELOCATION ................................................................................................ 3


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SECTION 1 GENERAL INFORMATION

1.1 SUMMARY STATEMENT

The Maryland Health Benefit Exchange (Exchange) is soliciting responses from qualified firms that are to provide Independent Verification and Validation (IV&V) services during the Design, DevelopmentImplementation (DDI) of the Maryland Health Insurance Exchange (HIX) system. The DDI will be perfby a System Integrator (SI) that was selected based upon vendor responses to a separate solicitation(Solicitation DHMSO294031 Support Maryland Health Benefit Exchange to Implement the AffordablCare Act (ACA). Other contracted entities or State Agencies contributing to the overall HIX effort mayfall within the Scope of review for the IV&V service provider. The Exchange reserves the right to cathis solicitation at any time. It is theExchanges intention to obtain services, as specified in this RFP, froma Contract between the successful Offeror and the Exchange. Offerors, either directly or through thsubcontractors, must be able to provide all services and meet all of the requirements requested in thisolicitation. The Exchange intends to make a single award to the Offeror whose proposal is deemed to the most advantageous to the Exchange. Further, the Exchange reserves the right to award certainadditional work, as described herein, to the successful Offeror through Optional Task Orders.

1.1.1 OVERVIEW Signed into law by President Obama on March 23, 2010, the ACA requires States to begin operatingHealth Insurance Exchange by January 1, 2014 or to allow the federal government to operate an Exchanon their behalf. In legislation adopted April 12, 2011, the State of Maryland established its own ExchaThe Exchange will provideMarylands residents and small businesses with the opportunity to comparerates, benefits, and quality among insurance plans and enroll in products that best suit their needs. It alswill be the entity that evaluates eligibility for Medicaid, advance premium tax credits and other affordaprograms designed to make coverage more affordable for individuals below 400 percent of the fedepoverty level (FPL).

A critical element of making Marylands Exchangesuccessful is procuring IV&V services for the HIX. TheState of Maryland has elected to establish a single IT infrastructure to evaluate eligibility for Exchaplans (including the Small Business Health Options Program (SHOP)Medicaid, Maryland Childrens HealthProgram (MCHP), and advance premium tax credits and cost-sharing reductions. The State of Marylamay eventually integrate eligibility determinations for other human services programs into the HIX, andsystem that the Exchange seeks to validate through this RFP must be able to serve as a platform for thperformance of these functions.

To comply with federal requirements, Maryland must successfully develop and test its new eligibility enrollment system by no later than the Spring of 2013. While Exchange coverage will not be effective January 1, 2014, the Exchange must be prepared to begin pre-enrolling people by October 1, 2013. In liof this aggressive timeline and the expansive scope of the work required, Maryland will implement its system in phases, beginning with core HIX and Medicaid functions. These phases are detailed in secti1.1.2. The IV&V vendor will provide critical input as to whether Maryland is on track to meet its fedmandated requirements as well as state specific requirements. Additionally, the IV&V vendor will plkey role in preparing for and providing evidence for Marylands Exchange certification activities with CMS inaccordance withCCIIOsBlueprint for Approval of Affordable State-based and State Partnership InsuranceExchanges.


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1.1.2 SCOPE OFWORK This solicitation seeks a firm to provide the IV&V services for the Maryland HIX program phase 1a anThe State envisions a team of highly qualified, experienced consultant staff that will be dedicated to teffort, which will be divided into two separate review periods: Pre-Certification IV&V ReviewOperational Readiness IV&V Review. Detailed description of the services to be provided is containeSection 2 of this RFP. Prospective offerors are encouraged to gain an understanding of the HIX projectreviewing material in the RFP attachments. The anticipated duration of this contract is for one (1) ywith an optional six (6) month extension period. The base period will include both the Pre-Certificationthe Operational Readiness review periods.

There are multiple stakeholder organizations that the IV&V vendor will interact with in the performanceduties. The IV&V Contract Monitor will be the principal contact for the IV&V service provider arecipient of all IV&V deliverables. Additionally, the IV&V service provider will have access to the fostakeholder organizations whose leadership and staff will be available to provide detailed informationtheir roles on the project as well as any information pertinent to the performance of the IV&V assessmen

The Department of Health and Mental Hygiene(business and technical leadership of the States MedicaidProgram)

The Department of Human Resources(business and technical leadership of the Statesprocesses fordetermining eligibility for social services programs, including Medicaid)

The Maryland Health Benefit Exchange (business and technical leadership of Marylands Individual andSHOP Exchanges)

The HIX Project Management Office (overall program management and technical implementationcoordination)

The HIX Systems Integrator (prime contractor for the development of the HIX system and liaison to COTSproduct vendors for eligibility and enrollment, plan management, etc.)

The prime contractor for the HIX DDI is Noridian Administrative Services, LLC (NAS). The primaryvendors are IBM Curam for affordable health insurance eligbility and enrollment, and Connecture for Qplan management, presentment, and selection. Additionally, other vendors and stakeholders may bidentified over the course of the IV&V contract. For example, the State plans to issue separate contrafor User Training and Production Systems Hosting and Operations. The activities of these additiostakeholders and vendors will fall under the scope of the HIX IV&V assessments.

The State may request the replacement or removal of any individual consultant staff member at any timbased solely upon the State's assessment of the individual's performance on the HIX IV&V project. TConsultant agrees to promptly replace staff members with individuals possessing equivalent or betqualifications, when requested to do so by the State.

Firms who are prime contractors or subcontractors on the HIX IT implementation team or the MarylHealth Reform Implementation Project Management Office (PMO) are not eligible to perform HIX services and proposals from such firms will not be evaluated.

1.1.3 PHASES OF THEHIX IMPLEMENTATION To ensure it can meet ACA requirements, the Exchange plans to implement the HIX in three phases. Tfirst phase is focused on ensuring that Maryland meets the federally-imposed deadline for creating operational Exchange by January 1, 2014. In future phases, the State may establish a fully integrate


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1.2 HIGH-LEVEL OVERVIEW OF HIX REQUIREMENTS

The Table below provides a high-level description of the functional and technical capabilities required bythe HIX, along with the phase (i.e.,1a, 1b, 2, or 3) in which the Exchange expects to acquire thecapability. As noted above, the purpose of this RFP is to solicit proposals for the IV&V of Phase 1a andfunctionality, which covers selected Exchange functions and MAGI Medicaid eligibility determinations well as the SHOP.

Functional / TechnicalCapability Description

Phase Reference1a 1b 2 3Functional Capabilities

General Information and Pre-screening

The HIX will provide users withgeneral information about theExchange, the plans and the processthey will have to follow to get helppaying for their health insurance. Itwill also allow users to anonymouslyview information on their potentialeligibility for Maryland Health Assistance Programs and review theircoverage options.

X Attachment OSection 17.1

Application and Intake

The HIX will allow users, includingauthorized representatives acting onbehalf of someone else, to submit anapplication for coverage in a qualifiedhealth plan (QHP) and, if applicable,for a Maryland Health Assistance



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Phase Reference1a 1b 2 3Program. At their option, users will beallowed to establish an on-lineaccount to make it easier to updatetheir information over time.

Verification of Information The HIX will verify user informationelectronically using the federal datahub and existing State databases tothe maximum extent feasible. It alsowill support alternative ways to verifyincome (e.g., paper documentation)when electronic data are not availableor reliable. As part of verification, itwill send notifications to users;manage any disputes oververification; and maintain a record ofthe outcome of verifications.


Eligibility Determination Using the information it has gatheredand verified, the HIX will evaluateeligibility for Exchange coverage andMaryland Health AssistancePrograms. It also will have thecapacity to evaluate eligibility forindividual mandate exemptions. It willsend notifications to users of itsfindings and accept requests forappeal.

X Attachment PSection 17.4

Advance Premium TaxCredit/Subsidy Calculation

For eligible individuals, the HIX willcalculate the size of the advancepremium tax credit and cost-sharingreduction; determine and display thesize and/or level of any such credits;give customers the option to accept alower tax credit; and meet federalreporting requirements on tax credits.


Plan Presentment Plan Presentment - The HIX willprovide people with information on theQHPs or Medicaid managed careplans for which they are eligible andallow them to compare and selectplans based on price, quality, andother factors.


Plan Enrollment The HIX will facilitate enrollment intoQHPs and Medicaid managed careplans during initial, annual, andspecial enrollment periods. It willsend enrollment information to QHPs,Medicaid managed care plans, andMMIS; secure acknowledgements of



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Phase Reference1a 1b 2 3enrollment; send enrollment data toHHS; and maintain records ofenrollment. On at least a monthlybasis, the HIX will conduct areconciliation of enrollment data withQHP issuers.

Account/Case Management The HIX will support individuals,caseworkers, and potentially others(e.g., Navigators, authorizedrepresentatives) in tracking andmanaging cases over time.Specifically, it will allow for thetracking and management of all userinformation from intake andenrollment through eligibilitydetermination, redetermination, anddisenrollment. It will allow users toupdate accounts to reflect a change incircumstances and initiate any actionrequired as a result of the change.


Premium Payment andTracking

The HIX will provide individuals withoptions for making and trackingpremium payments to QHPs. It willdetermine premium paymentamounts, allow people to view theirpremium obligations, and allowpeople to make premium payments inaccordance with federal requirementsand Exchange Board decisions. Italso will allow families with childrenenrolled in MCHP to make premiumpayments through the HIX.


Insurance CarrierManagement

The HIX will be responsible forsupporting the management ofinsurance carriers that are doingbusiness with the Exchange. Thismay include supporting thecertification, recertification, anddecertification of QHPs; gatheringquality and other data on QHPs;participating in administration of riskadjustment; and gathering anddisplaying rate increase information.


SHOP Functions As needed depending on choicesmade by the Exchange, the HIX willevaluate the eligibility of smallbusinesses and their employees forSHOP coverage; allow qualified



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Phase Reference1a 1b 2 3employees and small businesses toenroll in coverage; and allow smallbusinesses to make a single,aggregated monthly premiumpayment on behalf of their employees.

Navigator Management Basic Functionality

For Phase 1a, the HIX will have thecapacity to provide Navigators with aportal that supports them in helpingpeople enroll in coverage; allowsthem to register for a Navigatoraccount; and provides them withinformation specific to Navigators.


Navigator Management Additional Functionality

The Exchange may issue OptionalTask Orders to expand the capacity ofthe HIX to support Navigators. (Astudy on this subject is schedule to becompleted by late December 2011.)

X TBD

Reporting The HIX will provide the Exchangewith the capability to produce dataand generate reports needed forquality control, research, compliancewith audits, and administration of theExchange and Medicaid eligibilitydeterminations.


Outreach BasicFunctionality

The HIX will support outreach effortsunder development by the Exchangeby providing the capacity tocommunicate with enrollees and trackthe effectiveness of the Exchangesoutreach initiatives.


Outreach AdditionalFunctionality

The Exchange may issue OptionalTask Orders to expand the capacity ofthe HIX to support outreach topotential enrollees in QHPs and MDhealth subsidy programs.

X TBD

Notices The HIX will support communicationwith customers; insurance carriers;employers; other State agencies;case workers; and Navigators.


Technical & Operational Capabilities Hosting The Hosting phase will require web-

hosting and infrastructure capabilitiesin order to support the HIX.

X AttachmentM

Operations A vendor will be selected to supportHIX data center operations by early2013.

X AttachmentN

Internal Quality Assurance The Exchange may conductperformance and/or compliance X

Attachment PSection 1


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Phase Reference1a 1b 2 3review and reviews of specific recordsor other data as necessary.

Training Product The SI vendor is responsible for

developing technical training materialsand programs to support thedevelopment and installation of theHIX.


User Through a Task Order the selected SIvendor may be requested to developand deliver training materials andprograms for HIX users, including butnot limited to, caseworkers andNavigators.


Documentation The SI vendor will develop, maintain,electronically store, print, anddistribute HIX documentation.

X Attachment P

Section 3Accounting The SI vendor will establish and

maintain a centralized accountingsystem in accordance with thestandards defined in the IT SI VendorRFP.

X Attachment PSection 4

Warranty The SI vendor will provide a warrantyfor all phases of HIX development,testing and implementation.


Maintenance As a result of a Task Order the SIvendor will be responsible for themaintenance of all software licenses,releases, and requisite infrastructurefor a period of up to five years afterthe completion of work in Phase 1a..

X Attachment

N

Configuration Management The SI vendor will be responsible forcompleting configuration managementresponsibilities in accordance with theguidelines established by theExchange.


TechRefresh

N-1 The SI vendor will describe itsmethodology for providing the mostcost-effective approach to refreshingthe HIX. The SI vendor is required tomaintain the system at N-1 or better ifselected for production maintenance.

X Attachment

P

Section 7

Hardware Through a Task Order the selected SIvendor may be requested to meet allhardware refresh requirementsoutlined in this RFP.

X AttachmentN

MITA / SOA Architecture The SI vendor will employ SOA totake advantage of current X



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Phase Reference1a 1b 2 3marketplace technology and allow forthe reuse of system functionalityamong the various businessfunctions.

Rules Engine The SI vendor will employ a state-of-the-art business Rules Engine orBusiness Process Managementsoftware to record business rules formany business functions defined inthis RFP.


Usability & Accessibility The SI vendor will provide web-basedHIX access, a system user interfacethat is easy to read, user-friendly, andthat displays all data elementsnecessary for a user to performhis/her job function. The interfaces willbe usable by individuals withdisabilities and those with limitedEnglish proficiency, as required underfederal and state law and guidance


Testing All Exchange software, includinginterface software and conversionsoftware, must successfully navigatesystem and user acceptance testing.


Change ControlManagement

The SI vendor will develop andmaintain a Change ControlManagement process that ensuresthe integrity of the HIX by preventingthe implementation of all processes,data, hardware, and software until thevalidity of the change has beenverified through the Exchange.

X Attachment P

Section 12

NetworkConnectivity

Development / Testing

The SI vendor shall provide thecomprehensive network infrastructurenecessary to support developmentand testing of the HIX.


Hosting /Operations

Through a Task Order the selected SIvendor may be requested to developa comprehensive networkinfrastructure that provides amechanism for trending systemperformance, network and servermonitoring.

X Attachment M Attachment

N

Online Storage The SI vendor shall manage thearchival of inactive files and reportingon online storage directories.


DataRequirement

MedicaidEligibility

The SI vendor shall apply MasterData Management (MDM) (including X



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Phase Reference1a 1b 2 3s and

Enrollmentbut not limited to Master Data Index(MDI)), data retention, dataconversion, and data quality controlper the requirements listed in thisRFP. The Offeror shall leverageexisting MDI across agencies wherepossible.

(DR 1 to DR12)

Non-Medicaid /

SocialServices

The SI vendor must be able to crossidentify clients with near 100 percentreliability and seamlessly exchangedata on shared clients and view clientservices and history across programsthrough the use of a shareddemographic database or equivalenttechnological solution.

X Attachment P

Section 15(DR 13)

Documentation Managementand Workflow

The SI vendor shall provide add-onfunctionality in the new HIX systemthat brings electronic documentmanagement capabilities as well asthe Workflow Management (WFM)solution with it.


Web Portal In order to provide quality customerservice to Medicaid consumers, theExchange stakeholders, and otherentities, a web portal shall bedeveloped that provides easy accessto information about program benefits,eligibility, policy, processes, andreports, as well as the ability tocommunicate readily with theExchange.


Call Center Through a Task Order the selected SIVendor may be requested to supporta toll-free hotline that providesassistance to consumers. (HHS isexpected to provide more specificinformation about the requirements forthe Exchange call center in the nearfuture.)

X AttachmentN

CRM The SI vendor shall provide aCustomer Relationship ManagementSystem for supporting Exchangeusers telephonically, and throughother mediums such as the webportal, email, IVR, and data imagingsystems.


Contractual Reporting The SI vendor shall ensure the HIXmeets all reporting requirements X



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Phase Reference1a 1b 2 3outlined within this RFP.

Interfaces MedicaidEligibility

andEnrollment

The SI vendor shall ensure the HIXmeets the interface requirementsnecessary for Medicaid Eligibility andEnrollment. The HIX must also bescalable to address future interfaceand integration needs.

X Attachment P

Section 2

Non-Medicaid /

SocialServices

Through a Task Order the SI vendormay be requested to establishappropriate interfaces, beyond thoserequired in Phase 1a, with existingsystems that make eligibilitydeterminations for Social Servicesprograms other than Medicaid.

X Attachment OSection 15

Interoperability Through a Task Order the SI vendormay be requested to work with allagencies, including but not limited toExchange, DHMH and DHR, to createa transparent and seamlessexperience for clients to access andapply for services including health andsocial services.


Security and Privacy The SI vendor shall ensure the HIXadheres to HIPAA, State securityguidelines, and any additional securityand privacy requirements definedwithin this RFP.


System / ApplicationAvailability

The HIX system and database shallmeet all availability and accessibilityrequirements defined in the IT SIRFP.


Other Evaluation of Non-MAGI

Medicaid EligibilityThe HIX may add the capacity toconduct Medicaid determinations forthe non-MAGI population (i.e.,seniors, people with disabilities, andindividuals in need of long-term careservices).

X TBD

Integration of SocialServices

The HIX may add the capacity toconduct eligibility determinations forsocial services programs, such as theSupplemental Nutrition AssistanceProgram (SNAP) and Temporary Assistance for Needy Families(TANF).

X TBD


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Attachment O, Business Requirements Document (BRD), provides further details on all of therequirements. The BRD will be modified in the future as needed to reflect the issuance of any neregulations or guidance from the federal government or the Exchange. The IV&V Vendor will ensure thaassessment activities include comprehensive treatment of all requirements specified in the BRD.

1.2

ABBREVIATIONS AND DEFINITIONSFor purposes of this RFP, the following abbreviations or terms have the meanings indicated below:

Term Definition

ACA Affordable Care Act, which consists of The Patient Protection and Affordable Care Act, asamended by the federal Health Care and Education Reconciliation Act of 2010.

BAFO Best and Final Offers

Best of Breed The best product of its type

BRD Business Requirements Document

CARES Client Automated Resource and Eligibility System

CCIIO Center for Consumer Information and Insurance Oversight

CD Compact Disc

CFDA Catalog of Federal Domestic Assistance

CHIP Childrens Health Insurance Program (Federal)

CIO Chief Information Officer

CM

Contract Monitor - The State representative for this project who is primarily responsible forcontract administration functions, including issuing written direction, monitoring this projecensure compliance with the terms and conditions of the contract, and ensuring on budget/ontime/on target (e.g., within scope) completion of the project.

CMMI Capability Maturity Model Integration

CMS Centers for Medicare and Medicaid Services

COMAR Code of Maryland Regulations available on-line at www.dsd.State.md.us

Contract The Contract awarded to the successful Offeror pursuant to this RFP.

COTS Commercial-off-the-Shelf

CRM Customer Relationship Management

CSR Customer Service Requests

DDI Design, Development, Implementation

DDR Detailed Design Review

DGS Maryland Department of General Services

DHMH Maryland Department of Health and Mental Hygiene
http://www.dsd.state.md.us/http://www.dsd.state.md.us/http://www.dsd.state.md.us/http://www.dsd.state.md.us/


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Term Definition

DHR Maryland Department of Human Resources

DLLR Maryland Department of Labor, Licensing and Regulation

EDI Electronic Data Interchange

EFT Electronic Funds Transfer

ELC Exchange Life Cycle

eMM eMaryland Marketplace

EPA Environmental Protection Agency

ePHI electronic Protected Health Information

ESB Enterprise Service Bus

EVMS Earned Value Management System

Exchange Maryland Health Benefit ExchangeFFP Firm Fixed Price

FIPS Federal Information Processing Standard

FISMA Federal Information Security Management Act

FOA Funding Opportunity Announcement

FPL Federal Poverty Level

FRD Functional Requirements Document

GUI Graphical User Interface

HHS Department of Health and Human ServicesHIE Health Information Exchange

HIPAA Health Insurance Portability and Accountability Act

HITECH Health Information Technology for Economic and Clinical Health Act

HIX Health Insurance Exchange Solution

IEEE Institute of Electrical and Electronics Engineers (JA)

ILC Investment Life Cycle

IO Information Operations

IRS Internal Revenue Service

IT Information Technology

IVR Interactive Voice Recognition System

IV&V Independent Validation and Verification

JAD Joint Application Development


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Term Definition

LAN Local Area Network

LDAP Lightweight Directory Access Protocol

Local Time Time in the Eastern Time Zone as observed by the State of Maryland

MAGI Modified Adjusted Gross Income

MarylandHealth AssistancePrograms

This term refers to: Advanced Premium Tax Credits, cost sharing reductions, Medicaid andMCHP

MBE A Minority Business Enterprise certified by the Maryland Department of Transportation unCOMAR 21.11.03

MCHP Maryland Childrens Health Program

MD Maryland

MDOT Maryland Department of Transportation

MDM Master Data Management

MDI Master Data Index

MIA Maryland Insurance Administration

MITA Medicaid Information Technology Architecture

MMIS Medicaid Management Information System

NAICS North American Industry Classification System

NHIN National Health Information NetworkNIEM National Information Exchange Model

NIST National Institution of Standards & Technology

No WrongDoor

The concept of allowing people to apply for multiple affordability programs using a single, unifiedprocess that does not require them to know in advance the program for which they are likely to qualif

Normal StateBusinessHours

Normal State business hours are 8:00 a.m. 5:00 p.m. Monday through Friday except StateHolidays, which can be found at:www.dbm.maryland.gov - keyword State Holidays.

NSA National Security Agency

NTP Notice to Proceed: Letter from Contract Monitor to Offeror stating the date the Offeror canbegin work subject to the conditions of the contract.

Offeror An entity that submits a proposal in response to this RFP

OLAP Online Analytical Processing

OSC Office of the State Comptroller
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Term Definition

OSHA Occupational Safety and Health Administration

OTHS Office of Technology for Human Services

PKI Public Key Infrastructure

PM Program Manager

PMBOK Project Management Body of Knowledge (JA)

PMI Project Management Institute (JA)

PMP Project Management Plan

PPM Project Portfolio Management

PPP Procurement Policies and Procedures

ProcurementOfficer

The Exchange representative for the resulting Contract. The Procurement Officer isresponsible for the Contract and is the only individual who can authorize changes to theContract. Exchange may change the Procurement Officer at any time by written notice to tOfferor.

QHP Qualified Health Plan

RFP Request for Proposals

SDD System Design Document

SDLC Software Development Life Cycle

SHOP Small Business Health Options Program

SI System Integrator

SLA Service Level Agreement

SNAP Supplemental Nutrition Assistance Program

SOW Statement of Work

SSCD System Security Consensus Document

State The State of Maryland

TANF Temporary Assistance for Needy Families

UAT User Acceptance Testing

UI User InterfaceUML Unified Modeling Language

WAN Wide Area Network

XML Extensible Markup Language

WBS Work Breakdown Structure

WCAG Web Content Accessibility Guidelines


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1.3 CONTRACT TYPE

The contract resulting from this solicitation shall be a Firm-Fixed-Price (FFP) contract for all work perfoby the successful bidder. For additionalservices, Vendors are requested to provide information on OfferorsCapability and Labor Ratesin the Offerors Financial Proposal as specified in section 3.5. Additionalservices may be procured through Task Orders if agreed to by both parties.

1.4 CONTRACT DURATION

The Contract resulting from this RFP shall be for a period for one (1) year beginning on or about Septem1, 2012 and ending on August 31, 2013. At the sole option of the Exchange, the contract period may extended for up to six (6) months. In addition, if the Exchange elects to issue a Task Order for additioservices, the Contract shall be extended for the applicable period. The Offeror shall provide services upreceipt of a Notice to Proceed (NTP) from the Procurement Officer.

1.5

PROCUREMENT OFFICERThe sole point of contact in the Exchange for purposes of this RFP prior to the award of any Contract is Procurement Officer at the address listed below:

Rebecca PearceMaryland Health Benefit Exchange4201 Patterson Ave., 4th FloorBaltimore, Maryland 21215Office Phone: (410) 358-5615Fax: (410) 318-8532E-mail: [email protected]

The Exchange may change the Procurement Officer at any time by written notice.1.6 CONTRACT MONITOR

The Contract Monitor for this contract after it is awarded is:Kevin YangMaryland Health Benefit Exchange4201 Patterson Ave.,Baltimore, MD 21215Phone Number: (410) 358-5615Fax Number: (410) 333-5941E-mail: [email protected]

The Exchange may change the Contract Monitor at any time by written notice.


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1.7 PRE-PROPOSAL CONFERENCE

A Pre-Proposal Conference will be held on August 3, 2012 beginning at 9 am Local Time, at the Univeof Maryland Baltimore College (UMBC) Tech Center. The address for the Tech Center is:

1450 South Rolling RoadBaltimore, MD 21227

Attendance at the Pre-Proposal Conference is not mandatory, but all interested Offerors are encouraged attend in order to facilitate better preparation of their proposals. The Exchange will attempt to answer evquestion but its responses may be subject to clarification later. Moreover, the responses given verbally State representatives are not binding upon the State and are for informational purposes. Shoulsubstantive issues be raised which cause the solicitation to be amended, all prospective Offerors knownhave received a copy of this RFP will receive the amendment(s).

As promptly as is feasible, after the conference, a summary of it and all questions and answers knownthat time will be distributed to all prospective Offerors known to have received a copy of this RFP. Tsummary will also be posted on eMaryland Marketplace (eMM).

In order to assure adequate seating and other accommodations at the Pre-Proposal Conference, pleasemail or email the Pre-Proposal Conference Response Form to the attention of the Procurement Officer (ssection 1.5) no later than July 31, 2012 at 10 am Local Time. The Pre-Proposal Conference ResponForm is included asAttachment E to this RFP. In addition, if there is a need for a sign languageinterpretation and/or other special accommodations for individuals with disabilities, please call Procurement Officer no later than July 31, 2011 at 10 am Local Time. The Exchange will makereasonable effort to provide such special accommodations.

1.8 EMARYLAND MARKETPLACE

Each Offeror must indicate its eMM vendor number in the Transmittal Letter (cover letter) submitted atime of itsTechnical Proposal submission in response to this RFP.

eMM is an electronic commerce portal administered by the Maryland Department of General Servi(DGS). In addition to using the Exchange website and possibly other means of transmission, the RFassociated materials, summary of the Pre-Proposal Conference, Offeror questions and Exchangeresponses, addenda, and other solicitation-related information will be provided via eMM and through Procurement Officer.

In order to receive a contract award, an Offeror must be registered on eMM. Registration is free. Gohttps://ebidmarketplace.com/ and click on Registration to begin the process, then follow the prompts.

1.9 QUESTIONS

Written questions from Offerors will be accepted by the Procurement Officer prior to the Pre-PropoConference. If possible, such questions will be answered at the Pre-Proposal Conference. (Substantivquestions may not be answered prior to the Pre-Proposal Conference, except at the discretion of thProcurement Officer). Questions may be submitted by mail, facsimile, or preferably by e-mail to Procurement Officer. Questions, both oral and written, will also be accepted from Offerors attending Pre-Proposal Conference. If possible and appropriate, these questions will be answered at the PreProposal Conference.
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Questions will also be accepted subsequent to the Pre-Proposal Conference and should be submitted in timely manner prior to the proposal due date to the Procurement Officer. Time permitting, answers tosubstantive questions that have not previously been answered, and are not clearly specific only to threquestor, will be emailed to all Offerors who are known to have received a copy of the RFP.

1.10

PROPOSALS DUE - DATE AND TIME An unbound original and five (5) bound copies of each proposal (technical and financial) must be receiby the Procurement Officer, at the address listed in section 1.5, no later than 3:00 pm Local Time o August 17, 2012 in order to be considered. An electronic version written onto a CD of the TechnProposal in MS Word format must be enclosed with the original Technical Proposal. An electronic verwritten onto a CD of the Financial Proposal in MS Word 2007 version or newer must be enclosed withoriginal Financial Proposal. Ensure that the CDs are labeled with the RFP title, RFP number, and Offename and packaged with the original copy of the appropriate proposal (technical or financial) (see Sect3.2 Proposals).

Requests for extension of this date or time will not be granted. Offerors mailing proposals should alsufficient mail delivery time to ensure timely receipt by the Procurement Officer. Proposals received byProcurement Officer after the due date, August 17, 2012 at 3:00 pm Local Time will not be considered.

Proposals may not be submitted by e-mail or facsimile.

1.11 DURATION OF OFFER

Proposals submitted in response to this RFP are irrevocable for the later of: 1) 180 days following closing date of proposals or of BAFOs if requested, or 2) 30 days following the date when any and protests related to this RFP have been finally resolved. This period may be extended at the ProcuremeOfficers request only with the Offerors written agreement.

1.12 REVISIONS TO THE RFP

If it becomes necessary to revise this RFP before the due date for proposals, addenda will be provided all prospective Offerors who were sent this RFP or are otherwise known to the Procurement Officer to hobtained this RFP. In addition, addenda to the RFP, made after the due date for proposals, will be posteon the Exchange web page and through eMMAddenda and will be sent only to those Offerors wsubmitted a timely proposal.

Acknowledgement of the receipt of addenda to the RFP issued after the proposal due date shall be in thmanner specified in the addendum notice. Failure to acknowledge receipt of an addendum does not reliethe Offeror from complying with its terms, additions, deletions, or corrections.

1.13 CANCELLATIONS & DISCUSSIONS

The Exchange reserves the right to cancel this RFP, accept or reject any and all proposals (in whole or part) received in response to this RFP, to waive or permit cure of minor irregularities, and to condudiscussions with all qualified or potentially qualified Offerors in any manner necessary to serve the binterests of the Exchange. The Exchange also reserves the right, in its sole discretion, to award a Contrabased upon the written proposals received without prior discussions or negotiations.


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1.14 ORAL PRESENTATION

Offerors may be required to make oral presentations to Exchange representatives. Offerors must confiin writing any substantive oral clarification of, or change in, their proposals made in the course discussions. Any such written clarification or change then becomes part of the Offerors proposal and isbinding if the Contract is awarded. The Procurement Officer will notify Offerors of the time and place opresentations. The Exchange has tentatively scheduled oral presentations starting August 24, 2012.

1.15 INCURRED EXPENSES

The Exchange will not be responsible for any costs incurred by an Offeror in preparing and submittinproposal, in making an oral presentation, in providing a demonstration, or in performing any other activrelative to this solicitation.

1.16 ECONOMY OF PREPARATION

Proposals should be prepared simply and economically and provide a straightforward and concidescription of the Offeror's proposals to meet the requirements of this RFP.

1.17 PROTESTS

Any protest related to this solicitation shall be subject to the provisions of the Procurement Policies Procedures of the Exchange (PPP). A copy of the PPP may be found on the website of the Exchange ahttp://dhmh.maryland.gov/healthreform/exchange/index.html.

1.18 DISPUTES

Any contract dispute related to the resulting Contract shall be subject to the Disputes provision set forththe Contract, which isAttachment A to this RFP.

1.19 MULTIPLE OR ALTERNATE PROPOSALS Neither multiple nor alternate proposals will not be accepted.

1.20 PUBLIC INFORMATION ACT NOTICE

An Offeror should give specific attention to the clear identification of those portions of its proposal thconsiders confidential and/or proprietary commercial information or trade secrets, and provide justificawhy such materials, upon request, should not be disclosed by the Exchange under the Public Informati Act, Md. Code Ann., State Government Article, Title 10, Subtitle 6. This confidential and/or propriinformation should be identified by page and section number and placed after the Title Page and before tTable of Contents.

1.21 OFFEROR RESPONSIBILITIES

The selected Offeror shall be responsible for all products and services required by this RFP. Asubcontractors must be identified and a complete description of their role relative to the proposals mustincluded in the Offerors proposal. Additional information regarding Minority Business Enterprise (MBE)subcontractors is provided under paragraph 1.24. If an Offeror that seeks to perform or provide tservices required by this RFP is a subsidiary of another entity, all information submitted by the Offe
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such as, but not limited to, references and financial reports shall pertain exclusively to the Offeror unlthe parent organization will guarantee the performance of the subsidiary. If applicable, the Offerorsproposal must contain an explicit statement that the parent organization will guarantee the performancethe subsidiary.

1.22

STANDARD CONTRACTBy submitting an offer in response to this RFP, an Offeror, if selected for award, shall be deemed to haaccepted the terms and conditions of this RFP and the Contract, attached herein asAttachment A. Anyexceptions to this RFP or the contract must be raised prior to offer submission. Changes to the solicitator contract made by the Offeror mayresult in rejection of the Offerors proposals.

1.23 PROPOSAL AFFIDAVIT

A proposal submitted by an Offeror must be accompanied by a completed Bid/Proposal Affidavit. A copthis Affidavit is included asAttachment B of this RFP.

1.24

CONTRACT AFFIDAVIT All Offerors are advised that if a Contract is awarded as a result of this solicitation, the successful Offwill be required to complete a Contract Affidavit. A copy of this Affidavit is included asAttachment C of thisRFP. This Affidavit must be provided within five (5) business days of notification of proposed Conaward, however, to speed processing the Offeror is urged to include it with the Technical Proposal.

1.25 MINORITY BUSINESS ENTERPRISES

A minimum overall MBE sub-contractor participation goal of 30%, with subgoals of 7% for Af American-owned MBEs, 2% for Hispanic-American-owned MBEs, and 8% for women-owned MBEsbeen established for the services resulting from this contract.

An Offeror must include with its offer a completed Certified MBE Utilization and Fair Solicitation A(Attachment D-1) whereby:

(1) The Offeror acknowledges the certified MBE participation goal or requests a waivcommits to make a good faith effort to achieve the goal, and affirms that MBEsubcontractors were treated fairly in the solicitation process.

(2) The Offeror responds to the expected degree of Minority Business Enterprise participatias stated in the solicitation, by identifying the specific commitment of certified MBEs at time of submission. The bidder or Offeror shall specify the percentage of contract valuassociated with each MBE subcontractor identified on the MBE Participation Certificatio

If a bidder or Offeror fails to submit Attachment D-1 with the bid or offer as required, theProcurement Officer shall deem the bid non-responsive or shall determine that the Offeror is notreasonably susceptible of being selected for award.

Offerors are responsible for verifying that the MBE(s) selected to meet the subcontracting requirement subsequently identified inAttachment D-1 is appropriately certified and has the correct NAICS codesallowing it to perform the intended work. The MDOT MBE Directory may be found on the Wehttp://mbe.mdot.State.md.us/directory/.

Offerors, including those Offerors that are certified MBEs, shall:
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Identify specific work categories within the scope of the procurement appropriate fsubcontracting.

Solicit certified MBEs in writing at least 10 days before bids or proposals are due, describing identified work categories and providing instructions on how to bid on the subcontracts.

Attempt to make personal contact with the certified MBEs solicited and to document theattempts.

Assist certified MBEs to fulfill, or to seek waiver of, bonding requirements.

Attend pre-bid or other meetings the procurement agency schedules to publicize contractinopportunities to certified MBEs.

Within 10 working days from notification that it is the apparent awardee or from the date of the acaward, whichever is earlier, the apparent awardee must provide the following documentation to tProcurement Officer.

(1) Outreach Efforts Compliance statement (Attachment D-2)

(2) Subcontractor Project Participation statement (Attachment D-3)(3) If the apparent awardee believes a waiver (in whole or in part) of the overall MBE goal

of any sub goal is necessary, it must submit a fully documented waiver request.

(4) Any other documentation required by the Procurement Officer to ascertain Offerresponsibility in connection with the certified MBE participation goal.

If the apparent awardee fails to return each completed document within the required time, theProcurement Officer may determine that the apparent awardee is not responsible and therefore noteligible for contract award. If the contract has already been awarded, the award is voidable.

A current directory of certified Minority Business Enterprises is available through the Maryland S

Department of Transportation, Office of Minority Business Enterprise, 7201 Corporate Center Drive, PBox 548, Hanover, Maryland 21076. The phone numbers are 410-865-1269, 1-800-544-6056 or TTY 4865-1342. The directory is also available at http://www.mdot.State.md.us. The most current and up-to-dateinformation on Minority Business Enterprises is available via this website.

1.26 ARREARAGES

By submitting a response to this solicitation, each Offeror represents that it is not in arrears in the paymof any obligations due and owing the State or the Exchange, including the payment of taxes and employbenefits, and that it shall not become in arrears during the term of the Contract if selected for Contraaward.

1.27 PROCUREMENT METHODThis Contract will be awarded in accordance with the competitive sealed proposals process under PPPII.B.

1.28 VERIFICATION OF REGISTRATION AND TAX PAYMENT

Before a corporation can do business in the State it must be registered with the Department o Assessments and Taxation.
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Address: State Office Building, Room 803301 West Preston StreetBaltimore, Maryland 21201Web Address: http://www.dat.State.md.us/sdatweb/datanote.html

It is strongly recommended that any potential Offeror complete registration prior to the due date for recof proposals. An Offerors failure to complete registration with the Department of Assessments andTaxation may disqualify an otherwise successful Offeror from final consideration and recommendationContract award.

The successful Offeror shall be responsible for ensuring that all Sub-Contractors meet these requiremenand further, that the Offeror and all Sub-Contractors shall meet these requirements for the duration of tcontract, including option years.

1.29 PAYMENTS BY ELECTRONIC FUNDS TRANSFER

By submitting a response to this solicitation, the Offeror agrees to accept payments by electronic fun

transfer unless the State Comptrollers Office grants an exemption. Payment by electronic funds transfer ismandatory for contracts exceeding $100,000. The selected Offeror shall register using the COT/GAD XVendor Electronic Funds (EFT) Registration Request Form. Any request for exemption must be submito the State Comptrollers Office for approval at the address specified on the COT/GAD X-10 form and mustinclude the business identification information as stated on the form and include the reason for texemption. The COT/GAD X-10 form can be downloaded at:

http://compnet.comp.State.md.us/gad/pdf/GADX-10.pdf

1.30 LIVING WAGE REQUIREMENTS

Whilethe Exchange is an exempt unit under Division II of the State Finance and Procurement Article, theExchange requires the Offeror to pay the living wage amounts, as contemplated by Title 18 of the StaFinance and Procurement Article and any accompanying regulations. Additional information regardingStates Living Wage requirement is contained inAttachment G entitledLiving Wage Requirements forService Contracts. If the Offeror fails to complete and submit the required Living Wage documentation, thExchange may determine an Offeror to be not responsive.

Offerors and Sub-Contractors shall pay each covered employee at least (see amounts athttp://www.dllr.State.md.us/labor/prev/livingwage.shtml) per hour. The contract resulting from thissolicitation will be deemed to be a Tier 1 contract.

Information pertaining to reporting obligations may be found by going to the Department of Labor, Licenand Regulation (DLLR) Website http://www.dllr.State.md.us/labor/ and clicking on Living Wage.

1.31 PROMPT PAYMENT POLICY

The successful Offeror must comply with the prompt payment requirements set forth in the Contrresulting from this solicitation (see Attachment A). Guidance for prompt payment of subcontractors cafound in the Prompt Payment Policy Directive issued by the Governors Office of Minority Affairs and dated August 1, 2008. Additional information is available on the GOMA website at:

http://www.mdminoritybusiness.com/documents/PROMPTPAYMENTFAQs_000.pdf
http://www.dat.state.md.us/sdatweb/datanote.htmlhttp://www.dat.state.md.us/sdatweb/datanote.htmlhttp://compnet.comp.state.md.us/gad/pdf/GADX-10.pdfhttp://compnet.comp.state.md.us/gad/pdf/GADX-10.pdfhttp://www.dllr.state.md.us/labor/prev/livingwage.shtmlhttp://www.dllr.state.md.us/labor/prev/livingwage.shtmlhttp://www.dllr.state.md.us/labor/http://www.dllr.state.md.us/labor/http://www.dllr.state.md.us/labor/http://www.mdminoritybusiness.com/documents/PROMPTPAYMENTFAQs_000.pdfhttp://www.mdminoritybusiness.com/documents/PROMPTPAYMENTFAQs_000.pdfhttp://www.mdminoritybusiness.com/documents/PROMPTPAYMENTFAQs_000.pdfhttp://www.dllr.state.md.us/labor/http://www.dllr.state.md.us/labor/prev/livingwage.shtmlhttp://compnet.comp.state.md.us/gad/pdf/GADX-10.pdfhttp://www.dat.state.md.us/sdatweb/datanote.html


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1.32 FEDERAL FUNDING ACKNOWLEDGEMENT AND CERTIFICATIONS

This solicitation does include federal funds. The source of these federal funds is: Department of Health Human Services. The CFDA number is: 93.525. The conditions that apply to all federal funds awardedthe Department are contained in Federal Funds Attachment H. Any additional conditions that apply touse of federal funds under this contract are contained in Federal Funds Attachment H. Acceptance of tagreement indicates your intent to comply with all conditions, which are part of this agreement.

1.33 CONFLICT OF INTEREST AFFIDAVIT AND DISCLOSURE

All Offerors are advised that if a Contract is awarded as a result of this solicitation, the successful Offerspersonnel and each of the participating subcontractor personnel shall be required to complete agreemensuch as Attachment I Conflict of Interest Affidavit and Disclosure.

1.34 RETAINAGE

Ten percent (10%) of each invoice shall be held by the Exchange as retainage. If the successful Offerawarded a Contract fails to meet the requirements as defined in the Contract, the Offeror shall rectify performance problem or complete the specification to the satisfaction of the Contract Monitor within t(30) days or as directed by the Contract Monitor, at no cost to the Exchange. If the Contract Monitor issatisfied within this timeframe, the Contract Monitor may require forfeiture of the retainage.

The Offeror shall submit a separate invoice for the retainage release no earlier than six months (6) after tend of the base period of the contract. The Offeror shall track the cumulative retainage amount and dispthis amount on the invoices until the retainage is released by the Contract Monitor.

1.35 COTS SOFTWARE

In any response to this RFP in which an Offeror proposes the purchase of any COTS software, an Offershall specifically identify in its proposal the brand name, and other specifics for each product of COsoftware proposed for use by the State, the quantity needed, and a selling price for which it will provide COTS software.

By responding to this RFP and accepting a contract award, an Offeror specifically agrees that for aCOTS software that it proposes for use by the State in response to this RFP, the State will have the rightpurchase the COTS software from another source, instead of from the selected Offeror.

The State requires that the Offeror price individual software modules separately. The State reserves thright to purchase individual software modules separately without having to purchase all software moduThe State also requires that the Offeror provide fully functional evaluation software and multiple-ulicenses for purchase upon award of contract. All functionality must be available in the evaluation softwa

1.36 WITHDRAWALSProposals may be withdrawn by written notice to the Procurement Officer prior to the closing date/deadfor submission of proposals.


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1.37 SUBSTITUTION OF PERSONNEL

All personnel described in the Offeror s proposal, or identified at the initiation of theContract as key staff orkey personnel, shall perform continuously for the duration of the contract and for so long as performancsatisfactory to the Contract Monitor.

The Offeror may not substitute keypersonnel, other than by reason of an individuals death, sudden illness,termination of employment, or other extraordinary circumstances without the prior written approval ofContract Monitor. To replace any key personnel specified in the Offeror s proposal, theOfferor shall submitto the Contract Monitor: a) a detailed explanation of the reason(s) for the substitution request; b) tresumes of the proposed substitute personnel; c) the official resume of the current personnel focomparison purposes; and d) copies of any required credentials. The Offeror shall make this submissionleast two (2) weeks prior to the desired effective date of substitution. All proposed substitute personshall be interviewed by the Exchange, shall have qualifications at least equal to those of the replacepersonnel, and shall be approved by the Contract Monitor. The Contract Monitor will notify the Offerwriting of the acceptance, denial, contingent or temporary approval for a specified time limit, of proposed substitute personnel. The Contract Monitor will not unreasonably withhold approval o

requested key personnel replacement.The Contract Monitor may direct the Offeror to replace any staff whomthe Contract Monitor deems as beunqualified, non-productive, unable to fully perform his/her job duties, disruptive, or who has commitmajor infraction of law or State requirements, or for any other good faith basis. Normally, the ContMonitor shall give written notice of performance issues to the Offeror, clearly describing the problem delineating remediation requirement(s). The Offeror shall respond with a written remediation plan wthree (3) business days and implement the plan immediately upon written acceptance of the ContraMonitor. If performance issues persist, the Contract Monitor may give written notice or request immediate removal of person(s) whose performance is at issue, and determine whether a substitution required. If so required, the individual(s) shall be replaced within 15 days of the notice of performaissues.

If deemed appropriate in the sole discretion of the Contract Monitor, the Contract Monitor shall direct the individual be replaced immediately and without notice or a remediation plan.

1.38 TAX EXEMPTIONS

The State is generally exempt from Federal excise taxes, Maryland sales and use taxes, District oColumbia sales taxes and transportation taxes. Exemption certificates shall be completed upon request.

1.39 COMPLIANCE WITH FEDERAL HIPAA AND STATE CONFIDENTIALITY LAW

Based on the determination by the Exchange that the functions to be performed in accordance with Secti2 of this RFP constitute Business Associate functions as defined in HIPAA, the bidder shall executeBusiness Associate Agreement as required by HIPAA regulations at 45 CFR 164.501 and set forth Attachment J .

Offeror acknowledges its duty to become familiar with and comply, to the extent applicable, withrequirements of HIPAA, 42 U.S.C. 1320d et seq. and implementing regulations including 45 CFR Pa160 and 164. The Offeror also agrees to comply with the Maryland Confidentiality of Medical Record(Md. Code Ann. Health-General 4-301 et seq., MCMRA). These obligations include:


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A. As necessary, adhering to the privacy and security requirements for protected health informatioand medical records under Federal HIPAA and State MCMRA and making the transmission of electronic information compatible with the Federal HIPAA requirements;

B. Providing training and information to employees regarding confidentiality obligations as to heand financial information and securing acknowledgement of these obligations from employeesbe involved in the contract; and

C. Otherwise providing good information management practices regarding all health information amedical records.

The fully executed Business Associate Agreement must be submitted within ten (10) working days anotification of award or award of contract, whichever is earlier. Should the Business Associate Agreemnot be submitted upon expiration of the ten-day period as required by this solicitation, the ProcuremOfficer, upon approval of the Board of Trustees, may withdraw the recommendation for an award and man award to the next qualified Offeror.

Protected Health Information as defined in the HIPAA regulations at 45 CFR 160.103 and 164.501 meinformation that is individually identifiable; that is created or received by a healthcare provider, health ppublic health authority, employer, life insurer, school or university, or healthcare clearinghouse; and tharelated to the past, present, or future physical or mental health or condition of an individual, to the proviof healthcare to an individual, or to the past, present, or future payment for the provision of healthcare toindividual. The definition excludes certain education records as well as employment records held bcovered entity in its role as employer.


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SECTION 2 SCOPE OF WORK

2.1 OVERVIEW OF HIX IV&V WORK EFFORT

The overall goal of the HIX IV&V project is to assess whether Maryland and its IT vendor partners are otrack to implement the requisite technology for the Maryland Health Benefit Exchange in time for enrollconsumers into qualified health plans (QHPs) by October, 2013, as well as meeting all the other specifiedrequirements for Medicaid Expansion and Exchanges under the Affordable Care Act. The State requiresthe IV&V service provider to plan its work activities and deliverables around two major checkpoint revieeach with similar process steps and deliverables:

Pre-Certification IV&V Review (Contract Start through December 21, 2012)

Operational Readiness IV&V Review (January 1, 2013 August 30, 2012)

ThePre-Certification IV&V Review focuses on supporting Marylands effort to achieve approval by CMSCCIIO according to the Agencys Draft Blueprint for Approval of Affordable State-based and StatePartnership Insurance Exchanges. The IV&V service provider will conduct interviews, assessments, andissue reports according to the detailed tasks and deliverables listed in sections 2.5 and 2.6 of this RFPrespectively. The State will require the IV&V vendor to provide its assessments to CMS/CCIIO as towhether the designated Exchange activities in the Blueprint are built and operating as designed and incompliance with documented requirements and within the specified timelines of the certification processlist of specific CCIIO Blueprint assessments are provided inAttachment Q. The full Blueprint documentcan be accessed through the following link:http://cciio.cms.gov/resources/files/Exchangeblueprint05162012.pdf .

TheOperational Readiness IV&V Review focuses on assessing Marylands readiness to implement thenew HIX system and attendant operational processes prior to full implementation in Q3, 2013. The IV&service provider will be required to conduct the same assessments in the Pre-Certification IV&V reviewupdating findings based on progress made in 2013. A final report including a Corrective Action Plan (Cas needed will be produced by the IV&V Service Provider at the end of this assessment period.

In addition to the two main IV&V review checkpoints, the Exchange may optionally award a single six (month extension period as an optional task order for additional IV&V assessment and recommendationtasks. This optional task order may require the support of the IV&V vendor to assist in implementing threcommendations in the CAP. Additionally, the Exchange may decide that as a result of the DeliverableObservation Report (see section 2.6) that it will assign additional deliverables to the IV&V service provi

Any optional task order award will result in an official authorization of additional scope and may includebudget to perform those tasks. Additionally, the Exchange at its option may also issue a no-cost extensioto the IV&V service provider to complete the work for either the fixed price portion of the contract or thoptional task order period.
http://cciio.cms.gov/resources/files/Exchangeblueprint05162012.pdfhttp://cciio.cms.gov/resources/files/Exchangeblueprint05162012.pdfhttp://cciio.cms.gov/resources/files/Exchangeblueprint05162012.pdf


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2.2 GENERAL IV&V ASSESSMENT GOALS

The HIX IV&V service provider will assessMarylandsHIX implementation effort with particular focus in thefollowing areas:

A) Project management processes consistent with: 1) the project management knowledge areasdescribed in theProject Management Institutes (PMI) Project Management Body of Knowledge(PMBOK) with emphasis on Time, Scope, Risk, Quality, and Cost Management; 2) adherenceto the State of Marylands SDLC methodology; and 3) project management documents providedby the HIX IT vendors and subsequently approved by the State.

B) Project governance, meaning the extent to which the State and its HIX contractors haveeffectively: 1) defined roles and expectations among all internal and external stakeholders; 2)implemented an appropriate flow of project information among stakeholders; 3) instituted aprocess for review and response to project issues including escalation to the executivesponsors; and 4) instituted a process for executive approvals (for example, sign-off on SDLCdocuments) at appropriate project milestones.

C) Technical conformance of the IT solution with the project requirements, specifically: 1) allfunctional requirements defined by the State and required by CCIIO as conditions of operatingstate-based Exchange; 2) the architectural and non-functional requirements of the State and thfederal government as specified in the IT Vendor RFP, Support Maryland Health BenefitExchange to Implement the Affordable Care Act (ACA); and 3) State and federal standards andguidelines addressing software development methodologies, security and privacy requirementaccessibility, and other relevant standards listed in section 2.9 of this RFP.

D) Quality of implementation planning for the HIX with particular emphasis on ensuring thatMaryland is performing the requisite quality assurance tasks to achieve CCIIO certification inaccordance with theDraft Blueprint for Approval of Affordable State-based and StatePartnership Insurance Exchanges.

E) Feasibility of the project schedule, in light of project constraints, the need to integrate contractmanaged activities and agency managed activities, and the established timelines for thedelivery of the system.

2.3 GENERAL APPROACH FOR IV&V ACTVITIES

Using pre-defined checklists and similar tools founded on industry standards, the IV&V service providerstaff will interview and observe Maryland HIX Project Management staff, Exchange, DHMH and DHRProgram staff, the HIX Project Development Contractor staff (including any sub-contractors), and otherstakeholders. The IV&V service provider staff will observe project meetings and activities to understandprocesses, procedures, and tools used in the HIX Project environments, and review and analyze foradherence to accepted, contractually-defined industry standards, all applicable and availabledocumentation. The Exchange will ensure that the IV&V Service Provider has adequate access to projecpersonnel including those employed by the State and by the IT SI vendor and its subcontractors. As a


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result of these interactions and reviews of the applicable HIX Project documentation, the IV&V ServiceProvider will produce a structured, exception-based monthly assessment report that objectively illustratethe strengths and weaknesses of the Project. Additionally, two formal assessments will be required tosupport Marylands certification efforts with CCIIO as well as operational readiness. Finally, the IV&VService Provider will also provide recommendations for correcting the weaknesses that the assessment

reports identify in a CAP.

2.4 IV&V STANDARDS

Applicable tasks and activities will be performed in accordance with the Institute of Electrical andElectronics Engineers (IEEE) Standard 1012-2012. The IV&V Service Provider will also use all otherapplicable, lifecycle-appropriate IEEE Standards (e.g., 12207 Software Life Cycle Process; 703 SoftwarQA Plans; 1074 Developing Software Project Lifecycle Process; 828 Configuration Management Plans;and, 830 Requirement Specifications, etc., to name a few) in assessing the StatesHIX Project. Further,the IV&V Service Provider will employ the Capability Maturity Model Integrated (CMMI), and the PMBThird Edition, and the PMBOK - Government Extension, as additional standards by which to assess theHIX Project. Finally, the IV&V Service Provider will validate that all the State and federal standards citthe IT Vendor RFP and included in section 2.9 of this document such as the MITA Seven Standards andConditions are fully adhered to by the HIX Project team.

2.5 DETAILED TASKS

The following section contains lists of individual IV&V activities. All listed activities are mandatory anconsidered part of this solicitation. The State anticipates that the majority of task activities will beperformed in both the Pre-Certification and Operational Readiness review periods as appropriate and hasprovided preliminary guidance on the mapping between tasks and review periods in the chart below. Uporeview of the HIX implementation project plan and the schedule for the two separate IV&V review perio(Pre-Certification and Operational Readiness), the vendor shall make recommendations as to whether anyspecific tasks should be moved or deferred to a different review period. This task activity assignment wibe reviewed and approved by the Contract Monitor.

IV&V Project Management

TASKITEM TASK# REVIEWPERIOD TASKDESCRIPTION

IV&VManagement Plan

IM-1 PC As the first deliverable the IV&V provider shall develop an IV&V Management PlanThis plan shall describe the activities, personnel, schedule, standards, andmethodology for conducting the IV&V reviews. (seeWork Products for more details)

Conduct InitialReview

IM-2 PC Prepare and deliver an Initial IV&V report on the required activities. Report on statueach activity. (seeWork Products for more details)

Conduct OngoingReview(s)

IM-3 PC/OR Prepare and deliver Monthly IV&V reports on the required activities. Report on statof each activity and progress since the previous report. (seeWork Products for moredetails)

ManagementBriefing

IM-4 PC/OR Prepare and deliver a formal presentation(s) on the status of the IV&V project.Presented as required. (seeWork Products for more details)


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Project Management

TASKITEM TASK# REVIEWPERIOD TASKDESCRIPTION

ProjectSponsorship

PM-1 PC Assess and recommend improvement, as needed, to assure continuous executivestakeholder buy-in, participation, support and commitment, and that open pathways ocommunication exist among all stakeholders.

PM-2 PC Verify that executive sponsorship has bought-in t

md health benefit exchange ivandv rfp final~1(1)

Documents