Sources Sought Notice – Employer Sponsored Coverage Verification Solution

Notice Type: Sources Sought Notice

Posted Date: 12-JUN-15

Office Address: Department of Health and Human Services; Centers for Medicare & Medicaid Services; Office of Acquisition and Grants Management; 7500 Security Blvd.C2-21-15 Baltimore MD 21244-1850

Subject: Employer Sponsored Coverage Verification Solution

Classification Code: D - Information technology services, including telecommunications services

Solicitation Number: DB160321

Contact: Donald E. Bozimski, Phone 4107861355, Email [email protected] - Evelyn Dixon, Contracting Officer, Phone 410-786-1561, Fax 410-786-9088, Email [email protected]

Description: Department of Health and Human Services

Centers for Medicare & Medicaid Services

Office of Acquisition and Grants Management

Sources Sought Notice Title: Employer-Sponsored Coverage (ESC) Verification Solution Purpose of Notice This is a SOURCES SOUGHT NOTICE issued for the purpose of planning and market research. This is NOT a solicitation for proposals, proposal abstracts, or quotations and this does not obligate the Centers for Medicare & Medicaid Services (CMS) to award a contract.

The purpose of this notice is to obtain information regarding the availability and capability of qualified small businesses only (including 8(a), service-disabled veteran owned small business, HUBZone small business, and women-owned small business) that can provide an information technology (IT) development and data services solution in support of the CMS requirements for the Employer-Sponsored Coverage (ESC) Verification Solution for the Marketplace.

Prior to engaging in procurement activity for the ESC Verification Solution, CMS is issuing this Sources Sought Notice. The potential small businesses will need to demonstrate the ability to provide the services defined in this notice under the Requirements section below.

Background The Affordable Care Act (ACA) was enacted to assist millions of Americans in obtaining affordable health care coverage through Marketplaces. A Marketplace is a competitive place through which individuals and small businesses are able to purchase affordable private health insurance. Marketplaces serve as a one-stop shop where individuals are able to get information on their health insurance options, enroll in the plan of their choice, and be determined or assessed for eligibility for public programs/benefits, including Medicaid and the Children's Health Insurance Program (CHIP), and for advance payments of the premium tax credits and cost-sharing reductions to help lower the cost of private health insurance. Small businesses are able to purchase insurance through the Marketplace, via a program called the Small Group Health Options Program (SHOP), which is offered by each Marketplace. CMS, and specifically, Center for Consumer Information and Insurance Oversight (CCIIO), is broadly responsible for the Marketplace implementation.

Individuals who enroll in qualified health plans (QHP) through a Marketplace may be eligible for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs), that make health insurance more affordable and provide financial assistance to cover some or all costs for essential health benefits. Using information available at the time of application, the Marketplace determines whether an individual meets the ESC and other requirements for APTC determination, and the amount of APTC for which the tax household is eligible.

The Marketplace must attempt verification of ESC through the following data sources, to the extent they are available: * Any available data from the Office of Personnel Management (OPM), * The SHOP, and * Any other available sources that are approved by the U.S. Department of Health & Human Services (HHS) and that are sufficiently current, accurate, and minimize administrative burden.

CMS is working to develop and execute a long term strategy to provide a comprehensive, electronic ESC verification process by implementing a data source that will be utilized under 45 CFR [Section]155.320(d)(2)(i), targeted for implementation during Open Enrollment in Fall 2017, for 2018 coverage.

REQUIREMENTS CCIIO has a need to implement an ESC Verification Solution for the Marketplaces. The ESC Verification Solution shall consist of two primary parts: 1) an ESC Database and supporting IT system ("ESC Database"), and 2) supplemental ESC outreach/coordination work. The ESC Database shall be populated with information collected from employers, to complete verifications and ensure that consumers are receiving the appropriate financial assistance when they apply for Marketplace coverage. The ESC Database will contain data on the plans (and related other data) offered by millions of employers to their employees. In addition to the ESC Database design and build, supplemental work to support ESC outreach/coordination will be needed.

The work that will be addressed under a future contract will entail the following activities:

1. The design, development, and implementation of the ESC Database, integrated with CMS Data Services Hub, with the back-end logic of the Federally-Facilitated Marketplace (FFM) eligibility services, and with non-CMS systems as needed (such as integration with State Based Marketplaces (SBMs) or other sources). The effort will involve working with other CMS contractors to develop FFM and Hub integration functionality as well as to provide similar support to other requesting entities (e.g. SBMs). The design, development, and implementation of a public-facing component interface to the ESC Database to enable data intake from Enterprise Identity Management System (EIDM) authorized employers in synchronous and asynchronous modes. 2. Post-development operations and maintenance of the ESC Database (data, functionality, and supporting IT system), including the resolution of all operational and technical issues pertaining to integration with the Hub, FFM and other requesting systems. Manual ESC verification using sample data may be needed for consumers who cannot be verified using the ESC Database.

3. Provision of individual technical assistance, via an email help desk, for ESC data submitters who collectively represent millions of employers. The email help desk shall operate 5-7 days/week, and will provide 24/7 coverage during peak data submission cycles. During peak data submission, it is anticipated that volume may be approximately 250-650 inquiries per day.

4. The development and implementation of an outreach plan to encourage employers to submit data to the ESC Database. This includes educational support as well as obtaining the data from employers to populate the database.

The contractor should have the necessary infrastructure support to effectively interface with all stakeholders. This includes all Marketplaces and any other entities that CMS may define (i.e. Medicaid and CHIP agencies, SBMs). Anticipated Period of Performance The government expects that the final contract for this body of work will be for a base period of 12 months and four (4) twelve month option periods to be exercised at the discretion of the government.

Capability Statements In response to this Sources Sought Notice, CMS is seeking capability statements. Capability statements are NOT proposals and do not address price/cost. The contractor community is merely asked to provide information which may demonstrate that they have expertise and capacity to meet the requirements of this work as a prime contractor, with subcontractors as they deem necessary.

Please identify the prime or subcontractor relationship when describing experience. If a subcontractor, [please provide the roles/responsibilities on the contract. Identify the organization that the work was with (CMS, DOD, VA, States, etc.) Also, please include the contract number. Please also include any teaming partner's experience/capabilities as it relates to this Sources Sought Notice.

For the purposes of responding to this notice, contractors should address the following experience and advanced knowledge:

1. IT System Experience Inside the CMS Firewall: Please describe the contractor's prior experience with, or equivalent capability in, building IT systems that reside within the CMS firewall, or within similar or equivalent firewall, including the following specific aspects: a. standards for design b. development c. connectivity d. interface e. security f. data transmission, e.g., eXpedited Life Cycle (XLC) model g. personally identifiable information (PII) h. prior application of CMS' Acceptable Risk Safeguards (ARS) i. creation of all artifacts necessary to receive an Authority to Operate (ATO) in CMS FISMA Controls Tracking System (CFACTS), as described in the Federal Information Security Management Act (FISMA). This shall also include the full sequence of a Security Controls Assessment (SCA). j. knowledge and experience meeting the data submission requirements set forth in the ACA, and related laws and regulations.

2. FFM IT System Experience: Contractor's prior experience in, or equivalent capability for, directly providing or supporting FFM IT systems, specifically: Healthcare.gov, or the Federal Data Services Hub.

3. Large Database Development Experience: Contractor's prior experience in, or equivalent capability for, designing, developing, and maintaining a large database such as that required by the ESC Verification Solution, including projected data flows and transaction volumes, a supporting IT system, and the ability to deliver a proven solution that meets the requirements of CMS.

4. Experience Developing Database Interfaces: Contractor's prior experience in, or equivalent capability for, developing interfaces that exhibit equivalent capability to that required for ESC Database integration with other CMS/SBM systems e.g., connecting through the Hub and integrating into the back-end logic of the FFM's individual application.

5. Database Front-End Development and Support Experience: Contractor's prior experience in, or equivalent capability for, developing and providing support for database front-ends that exhibit capability equivalent to that required for building and providing support for a public-facing component for the ESC Database to enable data intake from EIDM-authorized employers in synchronous and asynchronous modes.

6. Database Operations and Maintenance (O&M), Support, and User Technical Assistance: Contractor's prior experience in all activities related to operations, maintenance and support services for large databases with multiple interfaces equivalent to the ESC Database. This includes experience in operating help desks that offer individualized technical assistance to large numbers of database users.

7. Stakeholder Outreach Experience: Contractor's prior experience in conducting outreach activities equivalent in scale to that required for collecting ESC information from employers in order to populate the ESC Database. This includes experience serving as the primary liaison between CMS and stakeholder groups, such as employers.

8. Experience Working with Multiple Stakeholders: Contractor's prior experience working with multiple stakeholders, in a fast-paced and quickly-evolving environment, to deliver technical and operational functionality equivalent to that required for the ESC Verification Solution e.g., government and contractor personnel from Healthcare.gov, SHOP Marketplace, Federal Data Services Hub, SBMs, and Multidimensional Insurance Data Analytics System (MIDAS).

Responses Requested Please submit your responses no later than July 13, 2015 to Don Bozimski, Contract Specialist at [email protected] and cc: Evelyn Dixon, Contracting Officer at [email protected] in the following format:

* Microsoft Word (or PDF) document with page size 8.5 by 11 inches, with a minimum of 1" margins. * Times New Roman Font Size 12 with no less than single spacing between lines. * Submissions shall not exceed 16 pages. Cover Page is included in the total page count.

Please be advised that email-transmitted files over 5 megabytes are not delivered during standard working hours, are only released from the CMS server after 5:00 PM EST, and may affect the timeliness of your response.

Respondents are requested to state their capabilities and expertise in clear and concise language. Respondents are strongly encouraged to avoid use of excessive marketing and sales language.

Cover Page Respondents shall provide Cover Page that includes the following identifying information:

* RFI number, title, and date of issuance * DUNS * Company Name * Company Address * Company Point of contact, Phone and Email address * Current GSA Schedules appropriate to this effort * Current GWACs appropriate to this effort * NAICS code under which the company conducts business as a small business and socio-economic status of the small business as validated via the System for Award Management (SAM). All potential offerors must be registered in SAM located https://www.sam.gov/portal/SAM/#1

Confidentiality No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

Disclaimer and Important Notes This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted.

Link/URL: https://www.fbo.gov/spg/HHS/HCFA/AGG/DB160321/listing.html