Request For Proposal Number K521: Health Benefits (Insurance) Exchange Systems Integrator Services

RequestforProposalNumberK521
for
HealthBenefits(Insurance)Exchange

SystemsIntegratorServices

ReleasedDate:October28,2011
MandatoryPreProposalConferenceNovember8,2011
ResponsesDue:December8,20113:00PM

RFPK521
TableofContents
1 Introduction.................................................................................................................................1
1.1 PurposeofSolicitation.........................................................................................................1
1.2 Background.........................................................................................................................2
1.3 AcquisitionAuthority.........................................................................................................12
1.4 ContractTerm...................................................................................................................12
1.5 Definitions.........................................................................................................................12
1.6 Award...............................................................................................................................12
1.7 OverviewofSolicitationProcess........................................................................................13
1.8 AuthorityProvidedResources...........................................................................................13
2 Schedule....................................................................................................................................14
3 AdministrativeRequirements.....................................................................................................15
3.1 RFPCoordinator(ProperCommunication).........................................................................15
3.2 ProcurementWebSiteandVendorReferenceLibrary.......................................................15
3.3 (M)LetterofIntent;11/8/2011,3:00PMPST....................................................................16
3.4 (M)PreProposalConference;11/8/2011,9:00AMPST.....................................................17
3.5 VendorQuestions..............................................................................................................17
3.6 VendorComplaintsRegardingRequirementsandSpecifications........................................18
3.7 (M)ProposalContents.......................................................................................................18
3.8 (M)NumberofProposalCopiesRequired..........................................................................19
3.9 (M)ProposalPresentationandFormatRequirements.......................................................19
3.10 (M)DeliveryofProposals..................................................................................................20
3.11 CostofProposalPreparation.............................................................................................20
3.12 ProposalPropertyoftheAuthority....................................................................................20
3.13 ProprietaryorConfidentialInformation............................................................................21
3.14 WaiveMinorAdministrativeIrregularities.........................................................................21
3.15 ErrorsinProposal..............................................................................................................21
3.16 Amendments/Addenda.....................................................................................................22
3.17 RighttoCancel..................................................................................................................22
3.18 ContractRequirements......................................................................................................22
3.19 IncorporationofDocumentsintoContract.........................................................................22
3.20 BestandFinalOffer...........................................................................................................23
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RFPK521
3.21 NoCostsorCharges...........................................................................................................23
3.22 MinorityandWomensBusinessEnterprises(MWBE)........................................................23
3.23 NoObligationtoContract/Buy..........................................................................................23
3.24 NonEndorsementandPublicity........................................................................................23
3.25 WithdrawalofProposal.....................................................................................................23
3.26 OptionalVendorDebriefing...............................................................................................23
3.27 ProtestProcedures............................................................................................................24
3.28 SelectionofApparentlySuccessfulVendor........................................................................24
4 VENDORREQUIREMENTS...........................................................................................................25
4.1 (M)VendorMinimumQualifications.................................................................................25
4.2 (M)VendorProfile/LetterofSubmittal..............................................................................25
4.3 (M)ExecutiveSummary.....................................................................................................26
4.4 (M)SoftwareOwnership...................................................................................................26
4.5 (M)SinglePointofContact................................................................................................26
4.6 (M)VendorOrganizationalCapabilities.............................................................................27
4.7 (M)VendorAccountManager...........................................................................................27
4.8 (MS)ClientReferences......................................................................................................27
4.9 (M)IntellectualProperty...................................................................................................28
4.10 (M)FinancialRating...........................................................................................................28
4.11 (M)VendorLicensedtodoBusinessinWashington...........................................................28
4.12 (M)UseofSubcontractors.................................................................................................28
4.13 (M)PriorContractPerformance.........................................................................................28
4.14 (M)LetterofCredit............................................................................................................29
4.15 (M)Insurance....................................................................................................................29
4.16 (M)LocationofVendorsProjectDevelopmentTeam........................................................29
5 HealthBenefits(Insurance)ExchangeSystemRequirements....................................................30
5.1 (M)RiskManagement.......................................................................................................30
5.2 (M)ProjectManagementRequirements............................................................................30
5.3 (M)ExchangeBusiness/FunctionalRequirements..............................................................30
5.4 (M)TechnologyRequirements...........................................................................................30
5.5 (M)Warranty....................................................................................................................30
6 FinancialProposal......................................................................................................................32
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6.1 (M)GeneralProvisions......................................................................................................32
6.2 (M)FinancialProposalRequirements................................................................................32
6.3 (MS)FinancialRequirementsHealthBenefitsExchangeCompletion...............................33
6.4 (MS)OptionalTasks...........................................................................................................34
7 EVALUATIONPROCESS...............................................................................................................35
7.1 Overview...........................................................................................................................35
7.2 AdministrativeScreening...................................................................................................35
7.3 MandatoryRequirements..................................................................................................35
7.4 QualitativeReviewandScoring.........................................................................................35
7.5 VendorTotalScore............................................................................................................37
7.6 OralPresentations/Demonstrations,SectionofApparentlySuccessfulVendor..................37
7.7 ContractingProcess...........................................................................................................38
APPENDICES:
NOTE:AllAppendicesareprovidedasseparatedocuments.
AppendixA:(M)VendorOrganizationalCapabilitiesRequirements
AppendixB:(M)ProjectManagementRequirements
AppendixC:(M)Business/FunctionalRequirements
AppendixD:(M)TechnologyRequirements
AppendixE:(M)CertificationsandAssurances
AppendixF:ProposedContract
AppendixG:MWBECertification
AppendixH:ProtestProcedures
AppendixI:Checklist
AppendixJ:(M)ClientReferenceForms
AppendixK:(M)FinancialResponse
AppendixL:Glossary
AppendixM:DeliverableAcceptanceCriteria
AppendixN:CMSCollaborativeEnvironmentandLifeCycleGovernance
AppendixO:HBERequirementsMatrix
AppendixP:(M)EligibilityServiceRequirements
iii

SECTION1
1 Introduction
1.1 PurposeofSolicitation
TheWashingtonStateHealthCareAuthority(AuthorityorHCA)isinitiatingthisRequestfor
Proposals(RFP)tosolicitproposalsfromqualifiedvendorstoprovidedevelopment,implementationand
hostingservicestoimplementtheWashingtonHealthBenefits(Insurance)ExchangebyDecember2013.
TheExchangesolutionmustbeawebbasedsolutionhostedatasecurelocationintheUnitedStates
proposedbytheVendor.Theselectedvendorwillprovidethefollowing:
AhostingsolutionmeetingtherequirementsoftheExchangeintermsofhardware,software,
network,andinfrastructureservices
AnintegratedExchangesolutionbasedonasingleExchangeportalencompassingthesystem
capabilitiestosupportIndividualEligibilityandEnrollment,PlanManagement,Financial
Management,andSmallBusinessHealthOptionsProgram(SHOP);
OperationsandMaintenanceoftheExchangeforoneyear;withprovisionsforextensions.
ThesolutionbeingsoughtthroughthisRFPcompetitivesolicitationmayconsistofoneormore
commercialofftheshelf(COTS)softwareproduct(s)oracustomdevelopedsoftwareofferingora
combination.
Theinitialcontractwillbefordesign,development,andimplementationoftheExchangeSolutionby
December2013followedbyasixmonthwarrantyperiodandthenoneyearofOperationsand
Maintenancesupportwiththeoptiontoextendtheinitialcontractforanadditionalsixyears.
Theproposalwillincludethefollowingpricingelements:
Detailedfixedpricedcostsforthedevelopment,verification,certificationanddeploymentofall
Exchangetechnicalandfunctionalcomponents.
DetailedfixedpricecostsfortheoperationsandmaintenanceoftheExchangesystemsforthe
initialyear.
TheExchangePortalprovidedbythevendorwillusetheStateEligibilityServiceofferedbythestates
AutomatedClientEligibilitySystem(ACES),WashingtonStateEligibilitySystem,todetermineeligibility
forMedicaid,CHIPandTaxCredits.DetailsoftheintegrationbetweentheExchangePortalandtheState
EligibilityServiceandtheboundariesforeachsystem/servicearefurtherdefinedinAppendixPEligibility
ServiceRequirementsoftheRFP.
Asacontingency,intheeventthattheStateEligibilityServicewillnotbeavailableortheStatedecides
tohavetheExchangeVendorbuildouttheStateEligibilityService,eachproposingvendorisrequiredto
preparearesponseintermsofhowtherequirementsoftheStateEligibilityServiceasdescribedin
AppendixPcanbemet.
NotincludedwithinthescopeofthisRFPare:thirdpartyadministrationofrisklevelingfunctions,
customersupportandcallcenter,andprogramoperationsstaffofanykindoutsidetheOperationsand
MaintenanceoftheExchangesolution.
AppendixCofthisRFP,alongwiththeExchangeBusinessProcessModelsandtheirsupporting
documentsprovideinformationregardingtheExchangebusinessfunctions.AppendixD,theTechnical
ReferenceModelandtheSecurityBlueprint,alongwiththeirsupportingdocuments,provideinsight
regardingthetechnologyservicesrequiredfortheExchange.
StateofWashington HealthBenefitsExchangeSystem
HealthCareAuthority Page1 K521

1.2 Background
OnMarch23,2010,PresidentObamasignedintolawthePatientProtectionandAffordableCareAct.On
March30,2010,theHealthCareandEducationReconciliationActof2010wassignedintolaw.Thetwo
lawsarecollectivelyreferredtoastheAffordableCareAct(ACA).TheACAcreatesanopportunityto
reformthehealthinsurancemarketplaceinordertoprovideallAmericanswithquality,affordable
healthinsurancecoverage.Aprimaryfeatureofthenewlawistherequirementthatallstatesestablish
aHealthBenefitExchange(Exchange).Inessence,theExchangeisanorganizedmarketplacetohelp
consumersandsmallbusinessesbuyhealthinsuranceinawaythatpermitseasycomparisonof
availableplanoptionsbasedonprice,benefits,andquality.Bypoolingpeopletogether,reducing
transactioncosts,andincreasingpriceandqualitytransparency,HealthBenefitExchangescreatemore
efficientandcompetitivehealthinsurancemarketstofacilitatetheofferofqualifiedhealthplansfor
individualsandsmallemployers.
WhileACAprovidesstateswithsignificantlatitudeinhowreformisultimatelyimplemented,italsosets
forthexpectationsaroundconsumermediatedenrollmentprocesses,systemsarchitectureandsecurity,
coordinationamongstMedicaid,ChildrensHealthInsuranceProgram(CHIP)andHealthBenefits
ExchangesandPlans,sharingofITassetsamongstates,andmore.TheguidancecontainedinACA
ultimatelysetsthefoundationallayerofrequirementsforstates.Forinstance,asrequiredbytheACA,
thecorefunctionsofanExchangeincludethefollowingitems,notallofwhichareincludedinthe
requirementsforthisRFP:
Certification,recertification,anddecertificationofqualifiedhealthplans
Callcenter
Exchangewebsite
Premiumtaxcreditandcostsharingreductioncalculator
Qualityratingsystem
Navigatorprogram
EligibilitydeterminationsforExchangeparticipation,advancepaymentofpremiumtaxcredits,
costsharingreductions,andMedicaid
SeamlesseligibilityandenrollmentprocesswithMedicaidandotherStatehealthsubsidy
programs
Enrollmentprocess
Applicationsandnotices
Individualresponsibilitydeterminations
Administrationofpremiumtaxcreditsandcostsharingreductions
Adjudicationofappealsofeligibilitydeterminations
Notificationandappealsofemployerliability
InformationreportingtoIRSandenrollees
Outreachandeducation
FreeChoiceVouchers
Riskadjustmentandtransitionalreinsurance
SHOPExchangespecificfunctions
UnderACA,WashingtonisrequiredtoestablishanoperationalExchangetoofferqualifiedhealth
insuranceplanstoindividualsandsmallbusinessesbyJanuary1,2014.Onceimplemented,Washington
anticipatesthattheExchangewillserve160,000440,000individualandgroupcustomersin2014,
consistingof140,000410,000individualsinthenongroupmarketand20,00030,000employeesof
smallbusinesses.Furthermore,theExchangewillsupportanestimatedadditional180,000190,000

newMedicaidcustomers.InordertomeettheDepartmentofHealthandHumanServicesreadiness
determinationdeadlineofJanuary1,2013andtheExchangegolivedeadlineofJanuary1,2014,the
Authorityisfocusingonthreekeyareas:
AnalyzingthecurrentWashingtonhealthcareinfrastructure,translatingthefederal
requirementstothestatescircumstances,anddevelopingastrategy;
Operationssupportfoundedonthisstrategytoprovidethetechnologyandprogram
managementsupportthatwillimplementaneffectiveExchangeaddressinggovernance,
eligibilitydetermination,linkagetoothermajorsubsidizedprograms,customersupportand
educationaloutreach;
Continuouslyevaluatingprogramprocessesandoutcomestoensurethatthe
technology/operationalcomponentsoftheExchangeandsupportingsystemsaredeveloped
anddeployedinanoptimalmanner,protectingconsumerrights,andreviewinghealthplanand
providerdecisionsforcompliancewithbothfederalandstaterequirements.
ACAestablisheshealthinsuranceexchangeswhicharemarketsforindividualsandsmallbusinessesto
easilynavigatethehealthcaresystemandprovidesonestopshoppingtoassistconsumersintheir
selectionandpurchaseofhealthcare.Healthinsuranceexchangesmayberunbystatesorbythe
federalgovernmentandmustbeoperationalbyJanuary2014.WashingtonStateSB5445established
theintentoftheStateofWashingtontoestablishandimplementanExchange.
Tohelpleveragemoreefficienthealthcarepurchasing,andtoaddresskeyprioritiesabove,Washington
mergedtwokeyagencies;theWashingtonStateHealthCareAuthority(whichmanagedthestates
PublicEmployeeBenefitsProgram,includingmanaginghealthinsuranceplans)andtheMedicaid
PurchasingAdministration(whichmanagedWashingtonsMedicaidandmedicalassistanceprograms).
Simultaneously,inSpring2011,theAuthorityappliedforandreceivedaStateHealthExchangeGrantfor
planninganExchangeinWashingtonState.Authorizinglegislationwasalsopassedin2011(SSB5445),
whichestablishestheexchangeasapublicprivatepartnershipseparateanddistinctfromthestate.
TheexchangewillbeestablishedwithaBoardofDirectorsbyMarch15,2012,soproposingvendors
needtobeawareofthetransitionofresponsibilityfromHCAtotheexchangeinthistimeframe.The
grantwasusedtoidentifyanddocumentkeybusinessfunctionsandpolicydecisionsofastatebased
Exchange.Aspartoftheanalysisoftheinformationtechnologyinfrastructurenecessarytosupporta
statebasedExchange,theStateconductedadetailedInformationTechnologyGapAnalysisforthe
HealthBenefitExchange.TheITInfrastructurereviewandassessmentreportdevelopedahighlevel
understandingoftherequirementsoftheExchangeandreviewedtheStatescurrentMedicaid
technologyinvestmentsandarchitecture.Thisincludedassessmentsofsystemsthatcouldhave
potentiallybeenleveragedforthenewsolution,suchas:
AutomatedClientEligibilitySystem(ACES).Legacyeligibilitysystemthatsupportseligibility
determinationforalargenumberofprogramsincludingcash,medical,andfoodassistance.
(OperatedbyDepartmentofSocialandHealthServices)
WashingtonConnection.Statewideportalforselfscreening,applicationsubmission,renew
benefitsandreportchangesforTemporaryAssistanceforNeedyFamilies(TANF),Supplemental
NutritionalAssistanceProgram(SNAP),Medicaidandothermedicalprograms.(Operatedbya
collaborationbetweenstate,federal,localandcommunitybasedorganizations)
ProviderOne.ThestatesMedicaidmanagedinformationsystem(MMIS)usedforclaims
processingandasaproviderpaymentsystem.(OperatedbyHealthCareAuthority).
TheassessmentalsodevelopedatobearchitecturetosupporttheExchange,identifiedgapsinthe
InfrastructureneededtosupporttheExchange,assessedcapacityrequirementsofnewandexisting

technologyrequiredfortheExchange,evaluatedalternativestomeettheExchangerequirements,and
providedafinalInfrastructureAssessmentthatprovidedoptionsfortheStatetoconsiderandmakea
finaldecision.TheInfrastructureAssessmentcanbefoundontheAuthoritywebsiteat
http://www.hca.wa.gov/hcr/exchange.html.
Followingthetechnologyassessment,theAuthorityinitiatedthisWashingtonStateHealthBenefit
ExchangeProjecttodevelopandimplementanintegratedtechnicalsolution.Thus,theAuthorityis
seekingproposalsfromqualifiedvendorstoprovidedevelopment,implementationandhostingservices
fortheExchangesolution.
1.2.1 SolutionOverviewandScope
ThevisionforthenewExchangeisacustomwebbasedportalsolutionthatmustbeaccessibleby
externalExchangecustomersandstakeholders,integratedwithbackofficefunctionalitytosupport
Exchangestaff,processing,andcommunicationtotheCMSFederalDataServicesHub(CMSHub)which
includes:
Anintuitivewebportalthroughwhichresidentscanaccesssubsidizedandunsubsidizedhealth
insurance,includingpublicinsuranceprograms(e.g.MedicaidandCHIP),including:
o Individualenrollmentandplanselection
o SmallBusinessHealthOptionsProgram(SHOP)portalsupportingplanselectionand
enrollmentforsmallemployersandtheiremployeesinqualifiedSHOPhealthplans
Aconsumerfocustheportalwillstreamlinehealthplanselection,offerrealtimeeligibility
determination,andfacilitateenrollment.Consumersmustbeableto,inastreamlined,single
session,enterrequiredinformation,receiveaneligibilitydetermination,compareinsurance
plans,selectaplanandcompletetheenrollmenttransaction.
AutomatedinteractionwithstakeholdersitisanticipatedthatIssuers,Navigators,thirdparty
administrators,CentersforMedicareandMedicaidServices(CMS),andtheOfficeofInsurance
Commissioner(OIC)willinteractwiththeExchangewebportaland/orthroughdataexchanges
whereverpossibletoavoidmanualtransactionsandrekeyinginformation.
IntegrationwithexistingsystemitistheAuthoritysintenttoutilizetheexistingACESsolution
asaneligibilitydeterminationandnotificationservicesfortheExchangeforMedicaid,taxcredit
andcostsharingeligibilityfunctions.ACESwillalsocontinueperformingnotificationsto
ProviderOneforMedicaidandCHIPenrollments.TheExchangewebportalmustintegratewith
ACEStoperformtheservicesneededfortheExchange.
Backofficefunctionsincluding:
o Integrationwithastateeligibilityservice(providedbyACES)todetermineeligibilityfor
Medicaid/CHIP/BasicHealth/TaxCredits
o Systemcomponentstofacilitateenrollmentsintoqualifiedhealthplans
o Systemcomponentstocertifyandmanageinsuranceissuer,healthplanandprovider
data
o Financialmanagementcomponents(billing,receivables,generalandsubsidiaryledgers,
premiumaggregation,reporting,reconciliation)
o Reportingandbusinessanalyticscapability
o Identityandaccountmanagement
o Document/contentmanagement
o Notificationsservices

HostingServicesitisexpectedthattheproductionsolutionandallsupportingenvironments
behostedbythesuccessfulVendorsrecommendedhostingenvironment.
OperationsandMaintenancetheAuthorityrequestsvendorstoincludeononeyearof
operationsandmaintenanceoftheExchangeintheirbaseProposal,andtoprovidecostsforsix
additionalyears.
BecauseitisexpectedthatconsumerswillaccesstheExchangefromtheirhomesandotherlocations,
theExchangewebportalisexpectedtogenerallybeavailabletousersinthefield24hoursaday,seven
(7)daysaweek.Thefollowingconceptualdiagram(Figure1below)illustratestheAuthoritysconcept
forhowtheExchangewilloperate.NotethattheFunctionalAreaswithinthescopeoftheRFPare
shadedingray.
Figure1:WashingtonExchangeHighLevelBusinessProcessConcept

TheprimaryfunctionalcomponentsoftheExchangethatarewithinthescopeofthisRFParedefinedin
AppendixC.PleaserefertoAppendixCsectionsformoreinformationonthesolutionvisionforeach
function.
IndividualEligibilityTheIndividualEligibilitybusinessareaconsistsofbusinessprocessesand
functionalrequirementsforapplicationintakeandscreening,determiningeligibility,renewing
eligibility,andhandlingappeals(AppendixC,Section5.3.2.1).
IndividualEnrollmentTheIndividualEnrollmentbusinessareaconsistsofbusinessprocesses
andfunctionalrequirementsforenrollingparticipants,renewingenrollment,andconducting
enrollmentreports(AppendixC,Section5.3.2.2).
PlanManagementThePlanManagementbusinessareaconsistsofbusinessprocessesand
requirementsforacquiring,certifying,monitoring,renewing,andmanagingthewithdrawalof
qualifiedhealthplansandtheissuersthatoffertheseplans(AppendixC,Section5.3.2.3).
EligibilityandEnrollmentSHOPTheSHOPbusinessareaconsistsofbusinessprocessesand
functionalrequirementsforenrollingSHOPemployersandemployees,renewingenrollment,
andconductingenrollmentreports(AppendixC,Section5.3.2.4).
FinancialManagementFinancialManagementincludesAdvancePaymentsofthePremiumTax
Credit(APTC)andCostSharingReductions(CSR),PremiumProcessing(SHOPandIndividual),
DataCollection,andIssuerPaymentTransfers(includingtheflowoffundsforpaymentsand
chargesfortheriskspreadingprograms)(AppendixC,Section5.3.2.5).
ExchangePortal/UserExperienceTheExchangeportalwillprovideacustomerexperience
similartothatexperiencedbyinternetcustomersoftopcommercialserviceandretail
companies.TheuserexperiencewillbebasedonthedesignproducedbytheEnrollment2014
UXProject,andwillincludesomemobilefunctionality(AppendixC,Section5.3.2.6).
AdministrativeFunctionsincludeAuditandProgramIntegrity,Reporting,Business
IntelligencecapabilitiesandNotices(AppendixC,Section5.3.2.7).
ThebusinessprocessflowsandnarrativetobesupportedbytheExchangeareprovidedbythe
functionalareaintheBusinessFunctionalRequirementsfolderoftheExchangeVendorReference
Library(availableattheHCAProcurementWebSite;http://www.hca.wa.gov/rfp.html).Notethatthe
processflowsaredraftandmanybusinessandoperationaldecisionsthatimpacttheflowofworkare
stillunderdevelopmentandwillbethroughout2011.Proposingvendorsneedtobeawarethat
requirements,processflowsandotherdecisionsaffectingtheExchangesolutionarestillunder
development,pendingadditionalguidancefromCMS,theWashingtonStateLegislatureandthe
WashingtonExchangeBoard.TheAuthorityadvisesproposingvendorstoconsiderpotentialchangesin
requirementsduringtheprojectwhenidentifyingresourcesandcostsfordevelopingandimplementing
theExchange.
1.2.2 TechnicalEnvironment
TheVendormustproposeasolutionthatmeetsallAuthorityrequirementsandisconsistentwiththe
standardsandrequirementsoutlinedintheTechnicalReferenceModelandtheSecurityBlueprint
requirementsofthisRFP.TheVendorsproposedsolutionmustincludeprovisioningthedevelopment,
testing/verification,training,certificationandproductionenvironmentsthatwillbeusedtodevelop,
maintainandoperatetheExchange.
TheExchangesolutionmustbeawebbasedsolutionhostedatasecurelocation,intheUnitedStates,
proposedbytheVendor.TheVendoralsoneedstoprovidehostingservicesfortheExchange
development,testing/verification,trainingandcertificationenvironments.Thevendorisrequiredto
host,maintainandoperatetheExchangeinproductionforoneyear.TheselectedVendorwillbe

responsibleforproviding,installingandmaintainingallhardware,software,networkcomponentsand
otherinfrastructureelementsfortheExchange.
VendorsshouldnotethattheExchangerequireshandlingofFederalTaxInformation(FTI),Health
relateddata(HIPAA)andPaymentCardIndustry(PCI)data.TheSecurityBlueprintdocumentaddresses
someoftheconcernsrelatedtothehostingandhandlingofthesetypesofinformation.
VendorsareadvisedtoreviewtheExchangeTechnicalReferenceModel(TRM)document,akeyelement
oftheenterprisearchitecturespecificationfortheExchange.TheTRMandSecurityBlueprint
documentsarelocatedintheTechnologyRequirementssectionoftheExchangeVendorReference
Library.
1.2.3 Security
TheExchangemustcomplywiththerequirementsforsecurityoutlinedintheSecurityBlueprint.
TheSecurityBlueprintdefinesacompletesetofmanagement,operationalandtechnicalsecurity
controlstoprotecttheconfidentiality,integrityandavailabilityoftheExchangefunctionsand
information.Onceonboard,theVendorwillworkwiththeExchangeteamtodevelopadetailed
SecurityPlanforimplementingandoperatingthesecontrols.TheSecurityPlanwillensurecompliance
withtheHealthInsurancePortabilityandAccountabilityActof1996(HIPAA),thePaymentCardIndustry
(PCI)DataSecurityStandardforpaymentcardprocessing(electronicpayments)andthefederaltax
informationsafeguardingrequirementsdefinedbytheIRSintheTitle26oftheUnitedStatesCode
(U.S.C)section6103.
TheselectedVendorwillberesponsiblefortheimplementationandoperationsoftheSecurityPlan,
whichwilladdressataminimumallthecontrolsdefinedwithintheSecurityBlueprint.
VendorsareadvisedtoreviewtheSecurityBlueprintdocument,akeyelementoftheenterprise
architecturespecificationfortheExchange.TheSecurityBlueprintdocumentislocatedinthe
TechnologyRequirementssectionoftheExchangeVendorReferenceLibrary.
1.2.4 PlannedInterfaces
TheExchangemusthaveelectronicinterfacestosystemsexternaltotheExchangeorganization.These
interfacesmaybefilebasedorrealtime,dependingontheVendorsdesignapproach,theAuthoritys
businessneedsandbusinessrequirements,andtheconstraintsandrequirementsofeachsystem
interfacingwiththeExchange.Someexamplesofinterfacesareasfollows:
StateofWashingtonAgencyFinancialReportingSystem(AFRS)
ACES
CMSHub
OfficeofInsuranceCommissionersystems
InsuranceCompanysystems(Issuers)
WashingtonConnection
1.2.4.1 AFRS
AFRSisthestateownedaccountingsystemusedbyallstateagenciesandhighereducationinstitutions
inthestateofWashington.AFRSisalegacymainframefinancialsystemthathasbeeninproductionfor
over25years.Thesystemperformsallaspectsoftheaccountingprocess:thegeneralledger,accounts
receivable,accountspayable,balancesheets,etc.Accountinginformationisupdateddailybymostusers
ofthesystem.

1.2.4.2 ACES
ACESwillserveastheeligibilityservicefortheExchange,andcontinuehandlingtheinitiating
transactionsforenrollmentofMedicaidandCHIPmemberstoProviderone.AssuchACESwillreceive
thefollowingrequestsfromtheExchange.
Eligibilitydeterminationrequests
Medicaid/CHIPenrollmentrequests
Noticegenerationrequests
RequeststoverifyclientinformationtotheCMSFederalDataServicesHub(CMSHub)andother
Statesources
TheExchangewillalsoreceiveinformationfromACESincluding:
Eligibilitydetermination
Recordofeligibilitynoticesprovidedtoapplicants
UptodateMedicaid/CHIPmanagedcareplanenrollmentinformation
Datafromverificationsourcestoaddtoindividualaccounts/datacollection
NotificationofexistingMedicaid/CHIPindividualswhosecircumstanceshavechangedand
requirereferraltotheExchange
ItisimportantforbiddingVendorstonotethatACESwillbemodifiedtohandletheseservices
concurrentwiththeExchangedevelopment.Thesuccessfulvendorwillbeworkingcloselywiththe
ACESmodificationteamtosuccessfullyimplementtheseinterfacesandservices.
ACESProfile:ThissystemisusedbytheStateofWashington'sDepartmentofSocialandHealth
Services.ACESsupportstheoperationsofthedepartmentbyintegratingDSHSprograms(including
HCA/MPAMedicaidprogram)underasingle,clientbased,onlinesystem.TheACESsystemisatoolfor
determiningeligibility,issuingbenefits,managementsupport,andsharingofdatabetweenagenciesfor
Cash,MedicaidandFoodAssistanceprograms.OthersupportingfunctionsofACESincludecase
management,generatinglettersandcorrespondence,addressverification.
TheACESSystemwasoriginallyimplementedonApril18,1996.Thesystemfoundationwasbuiltusing
IBMIMSasabaseandCOBOLfortheprimarydevelopmentlanguageandrunsonz/os.Thesystemhas
evolvedsinceinception,andnowthelegacysystemisbeingdecoupledandnewfunctionalityisbeing
introducedunderACESOnline,usingtechnologieslikeJava,webservices,DB2,WebSphereMQ,CICS
TransactionGateway.ThenewfunctionalitybeingimplementedtakesadvantageofObjectOriented
Designprinciples,loosecoupling,andseparationofconcerns.About2530%oftheACESfunctionalityis
nowavailableusingACESOnline.However,theeligibilitydeterminationfunctionforallprograms
includingMedicaidisinlegacyCOBOLcode.
Goingforward,toprovidetheeligibilityservicefortheExchange,ACESwillimplementacommercially
availablebusinessrulesengine(IBMsILOG)whichwillsupporteligibilitydeterminationsforcurrent
humanservicesprograms(e.g.TANFandSNAP)aswellasthenewModifiedAdjustedGrossIncome
(MAGI)basedeligibilitydeterminationsfortheExchange.Additionally,theACESeligibilityservicewill
alsoprovidecapabilitytotheExchangetoqueryandexchangedatawiththeCMSHubforverification.
Lastly,theACESEligibilityServicewillalsogeneratenoticestoindividualsandapplicantsasitrelatesto
Medicaid/CHIP/BasicHealth/TaxCrediteligibilitydeterminations.
1.2.4.3 CMSHub
TheCMSFederalDataServicesHub(CMSHub)willprovideacentralpointofaccesstodataservices
fromdiversefederalagencies.CMSplanstodocumentandpublishHubintegrationwithotherfederal
stakeholdersinthenearfutureviaaBusinessArchitecturesupplement.Ingeneral,theCMSHubwill:

ProvidetotheExchange:
InformationonIssuersandPlans
PlanQualityandsilverratings
ValidationofMAGIincomeandCitizenshiptobeprovidedviatheACESeligibilityservice
ReceivefromtheExchange:
ExchangecertifiedIssuerandPlandata
Planquality,performanceandcomplaintdata
Enrollment
Financialtransactionsrelatedtotaxcredits,costsharingandissuerreimbursements
Detailedrequirements,dataanddesignspecificationswillbeprovidedbyCMSatafuturedate,atwhich
time,theinterfaceswiththeCMSHubcanbefurtherdefined.
1.2.4.4 OfficeofInsuranceCommissionerSystems
ThereareseveralOfficeofInsuranceCommissioner(OIC)systemsthathouseinformationabout
Issuers,rates,plans,providernetworksandcomplaints.Theselectedvendorwillworkwiththe
ExchangeandtheOICtofinalizealistofinterfacesneededtoshareandreceiveelectronicdatawiththe
OICsystems,andthetypeofinterface.Itiscurrentlyanticipatedthatinterfaceswillconsistoffile
sharingvs.realtimeintegration,butthevendorwillassistinthefinalrecommendedapproachforthese
interfaces.
1.2.4.5 Issuers
ItistheAuthoritysintenttoprovideelectronicmethodsforreceivingdatafilesandinformationfrom
Issuers,withapriorityongatheringhighervolumedatasetselectronically(suchasprovidernetworks).
TheselectedvendorwillworkwiththeExchangetofinalizealistofinterfacesneededtosharewithand
receiveelectronicdatafromtheIssuers,andthetypeofinterfacesrequired.Itiscurrentlyanticipated
thatinterfacesusedbetweentheExchangeandIssuerswillconsistofacombinationoffilesharing,data
entryscreens,andrealtimenotifications.Thevendorwillassistinthefinalrecommendedapproach
forelectronicallyinteractingwithandreceivingdatafromIssuers.Informationtobereceivedfrom
Issuersincludes:
Issuerdata
Planbenefitstructureandrates
QualityandPerformanceData
Monthlyprovidernetworkupdates
InformationtobeprovidedelectronicallytoIssuersincludes:
Enrollmentanddisenrollment
Aggregatedpremiumpaymentandinformation
TaxCreditinformation
1.2.4.6 WashingtonConnection
TheWashingtonConnectionportalisacollaborativeeffortbetweenstate,federal,localandcommunity
basedorganizations.Throughthisportal,theresidentscaneasilyandsecurelylearnaboutandapplyfor
availablesocialservicesprogramsandbenefits.WashingtonConnectionhasascreeningtoolthatallows
individuals/familiestodetermineiftheymayqualifyforbenefitspriortosubmittinganapplication.
Enhancementsplannedfor2011includetheabilitytoreporteligibilitychangesandrenewbenefits
online.ThemajorsoftwarecomponentsofWashingtonConnectionincludeWebSphereApplication
Server,WebSphereMQEnterpriseServiceBus,WebSphereiLogrulesengine,DB2,SQLServer,

COGNOS,Infosphereserver,andTivoliIdentityManagement.TheWashingtonConnectionportalis
basedonanopenarchitecture.Thisprovidesflexibilitytointegratewithotherapplicationsandor
benefitprovidersinWashingtonState.DataCollectedthroughWashingtonConnectionissenttoACES
foreligibilitydetermination.TheportalisownedandmaintainedbytheWashingtonDepartmentof
SocialandHealthServices,EconomicServicesAdministration.
InterfacesbetweentheExchangeandWashingtonConnectionwillconsistofreferrals.
IfaconsumerprovidesinformationtoWashingtonConnectionforbenefitsapplication,andif
theconsumerneedshealthinsurancefromtheExchange,WashingtonConnectionwill
electronicallyrefertheconsumerandproviderelevantinformationtotheExchange.
IfaconsumerprovidesinformationtotheExchange,andifadditionalbenefitsareavailableto
theconsumerthroughWashingtonConnection,theExchangewillelectronicallyreferthe
consumerandproviderelevantinformationtotheWashingtonConnection.
DatacollectedbyeithertheWAExchangeortheWAConnectionwillbesharedtominimizedata
entryandprovideanintegrateduserexperienceandinteroperabilityintermsofservices
coverage.
ThesuccessfulvendorwillworkwiththeWashingtonConnectionITprojectteamtodeterminethe
methodforandimplementasuccessfulreferralsprocess.
1.2.5 PhasedReleases
TheExchangemustbeimplementedinaseriesofphasedreleasesthatincrementallyprovide
functionalitytotheExchangeconsumers.Eachreleasemustbefullyfunctionalandprovideacomplete
workingsetoffeaturestotheusers.TherequirementsinAppendixCareorganizedbyfunctionalphase
anddescribethespecificfunctionalityrequired.Table1belowsummarizesthecontentofeachrelease
byfunctionalmodule.
Table1:ExchangeImplementationTimeline
Phase DeliverableFunctionality Preliminary FinalDetailed Operational Implementation
DesignReview Design Readiness
1 PlanManagement 4/1/2012 9/1/2012 4/1/2013 7/1/2013
2 SHOPEmployerFunctionality 4/1/2012 10/1/2012 5/1/2013 8/1/2013
3 SHOPEmployeeEnrollment 4/1/2012 12/1/2012 7/1/2013 10/1/2013
4 IndividualEligibility 4/1/2012 12/1/2012 7/1/2013 10/1/2013
5 IndividualEnrollment 4/1/2012 12/1/2012 7/1/2013 10/1/2013
6 FinancialManagement 4/1/2012 12/1/2012 7/1/2013 10/1/2013
7 AdministrativeFunctionality 4/1/2012 3/1/2013 10/1/2013 1/1/2014
TheimplementationdatesprovidedinTable1aboveareconstrainedbyCMSrequirementstoensure
thatindividualsandsmallbusinessemployeescanenrollandbeprotectedbyhealthinsuranceasof
January1,2014.Toaccomplishthisrequiresastagedimplementationoffunctionalityasfollows:
PlanManagementavailabletoissuersbyJuly1,2013tosetupQualifiedHealthPlans(QHP)
SHOPEmployerFunctionalityavailabletoemployersbyAugust1,2013foremployerstochoose
ofQHP(s)andidentifyemployeestoExchange
SHOPEmployeeEnrollmentandIndividualEligibility&Enrollmentsavailabletoindividualsand
SHOPemployeesbyOctober1,2013toverifyeligibilityandenrollinaQHPpriortoJanuary1,
2014.
1.2.6 HCAProjectGovernance

TodevelopthestatesExchange,theAuthorityhasdeployedaprojectgovernancemodelthatutilizes
bothstateandindustrybestpractices.Figure2belowprovidesagraphicrepresentingthecurrent
governancemodelwhichwillbeinplaceuntilMarch,2012.
InadditiontotheAuthoritystaffandVendor,theExchangeprojectwillinvolvestakeholdersandsupport
stafffrommultipleStateAgencies:
DepartmentofSocialandHealthServices
OfficeofInsuranceCommissioner
OfficeofFinancialManagement
OfficeofChiefInformationOfficer
Figure2:ProjectGovernanceModelPriortoMarch2012
InMarch2012,theExchangeBoardwillbeestablished,andwillputinplaceanewgovernancestructure
toguidetheremainderoftheExchangeproject.TheExchangeBoard,apublicprivatepartnership,will
beauthorizedtoapplyforandadministergrants,establishtheExchangeinformationtechnology
infrastructure,andundertaketheadministrativefunctionsnecessarytobeginoperationoftheexchange
byJanuary1,2014.
TheBoardwillconsistofsevenGovernorappointedmembersaswellasadditionalmembersincluding
theDirectoroftheHealthCareAuthorityandtheInsuranceCommissionerorhisdesignee(asanon
voting,exofficiomember).Onceestablished,theboardwillalsoestablishbylaws,ensuretransparency
andaccountabilityoftheentity,andhireanexecutivedirectorandotherstaffmembersofthe
exchange.UntiltheExchangeBoardisestablished,theAuthoritywillcontinuetoprovideleadershipin
developingtheExchange.

1.3 AcquisitionAuthority
ESSB5931201112,anactreorganizingandstreamliningcentralservicefunctions,powers,andduties
ofstategovernment,establishedtheOfficeoftheChiefInformationOfficer(OCIO).WhiletheOCIO
doesnotpurchaseforagencies,itregulatesthemannerinwhichstateagenciesmayacquire
informationtechnologyequipment,software,andservices.Inaddition,becausetheExchangePortalwill
beamajorITSystemthathassignificantstatewideimpact,theprocurementandcontractwillbefor
personalservicesundertheauthorityofthenewlyestablishedDepartmentofEnterpriseServices.The
AuthorityissuesthisRequestforProposal(RFP)pursuanttotherulesoftheOCIOandDES.TheOCIO
mustapprovetheselectionoftheApparentlySuccessfulVendorandtheawardofthiscontract.This
contractisalsorequiredtobefiledwithandapprovedbyDES.Workshallnotcommenceandpayment
shallnotbemadeuntilaminimumoften(10)workingdaysafterthedateoffiling,and,ifrequired,until
reviewedorapprovedbyDES.IntheeventDESfailstoapprovetheContract,theContractshallbenull
andvoid.
1.4 ContractTerm
1.4.1 ContractInitialTerm
TheinitialtermoftheContractresultingfromthisRFPwillcommenceonthedatelistedinSection2:
ScheduleandwillextendthroughJune30,2015.
Theinitialtermwillinclude:(i)thedesign,developmentandimplementationphase;(ii)theinitial
operationsandmaintenanceperiod;and(iii)the6monthwarrantyperiod.
Becauseofthephasedimplementationapproach,operationsandmaintenancewilloccurinparallelwith
theimplementationoftheExchangePortal.
TheoperationsandmaintenanceperiodwillbeginwhentheExchangePortalhasmovedinto
productionwhenallLevel1,2or3deficiencies(asdefinedinSection5.2.4.8.6ofAppendixB)have
beenremediedandretested.
AcceptanceoftheExchangePortalwilloccurwhenallDeficiencieshavebeencorrected.Ontheday
afterAcceptance,a6monthwarrantyperiodwillcommence,duringwhichtimeanydeficiencieswillbe
remediedtotheAuthorityssatisfactionatnoadditionalcost.
1.4.2 ContractRenewalTerms
TheAuthority,atitssolediscretion,mayextendtheOperationsandMaintenanceundertheContract
foruptosix(6)additionalyears.Suchrenewalsmayalsoincludeadditionaldevelopmentasrequiredby
lawchangesorothercircumstancesrelatedtotheimprovedfunctioningoftheExchangePortal.
1.4.3 SoftwareLicense
ThetermofanyCustomSoftwareLicensesresultingfromthisRFPshallbeperpetualastotheLicense.
1.5 Definitions
DefinitionsforthisRequestforProposalshallhavethemeaningsassignedtothemasprovidedin
AppendixL.
1.6 Award
Onlyone(1)ApparentlySuccessfulVendor(ASV)willbeidentifiedviathisprocurement.TheAuthority
intendstoawardonlyone(1)Contract.

1.7 OverviewofSolicitationProcess
Thesolicitationprocessofthisprojectissanctionedanddrivendirectlyfromfederallawandmandated
milestonestiedtogrants.FailuretomeetmandatedmilestonesputstheStateinjeopardyoflosing
federalgrantmonies.FromaStateperspective,theprocurementprocesshastemporarilyfalleninagap
betweentheformerInformationServicesBoard(ISB)[createdbytheStateLegislaturein1987]being
disbanded,andanewlyformedTechnologyServiceBoard(TSB)thatisinprocessofbeingformed.New
legislationeffectiveOctober1,2011,EngrossedSubstituteSenateBill5931(ESSB5931)formedtheTSB
andthenewOfficeoftheChiefInformationOfficer(OCIO).TheTSBfocusesprimarilyonITstrategic
visionandplanning;enterprisearchitecture;policyandstandards;andmajorprojectoversight,including
procurementendorsements.ThefirstTSBmeetingisnotscheduleduntiltheweekofNovember28,
2011.RegularlyscheduledquarterlymeetingsareplannedaftertheinitialmeetingstartinginJanuary
2012.
EffectiveOctober1,2011,theOCIOadoptedthepoliciesandstandardsfromtheformerInformation
ServicesBoardinaninterimstatuspendingreviewbytheOCIOandTSB.OCIOanticipatesfinalized
policiesbeingadoptedbyJanuary1,2012.
Withrespecttothisprocurement,andthecurrentgapsintimingoftheTSB,theStateplansto
coordinatewiththeOCIOtoensurepolicyandstrategicITplanningareadheredtoaswellasaligned
andintegratedwiththeExchangeprogramsfederalrequirements.
TheprocurementisinitiatedbythisRequestforProposal(RFP).Vendorswillcompeteto
build/integrate,implementandoperatetheExchange.Afterevaluationoftheproposals(Section7:
EvaluationProcess),theAuthorityandtheASVwillenterintoafixedprice,deliverablebasedcontract
throughwhichtheVendorwillbuild/integrateandimplementtheExchange.
Thissolicitationprocesswilloccurintwostages:
VendorProposalswillbeevaluatedbasedonMandatoryRequirements(pass/fail)and
MandatoryandDesirableScoredRequirements;and
TheAuthoritywillidentifythethree(3)*highestscoringvendorsasfinalists.Finalistswillpresent
theirprojectmanagementapproaches,demonstratetheirsolutionsandrespondtoAuthority
reviewerquestions.TheApparentlySuccessfulVendorwillbeselectedfromthefinalists.
*TheAuthorityreservestherighttoincreasethenumberoffinalistsifthescoresaresoclosetogethersoasto
createaclusterofmorethanthreeatthetopofthescoringrange.

1.8 AuthorityProvidedResources
VendorsshouldassumethattheAuthoritywillprovidethefollowingresourcestotheProject:
TechnologyStaff:ITSubjectMatterExpertsfromtheAuthoritysInformationTechnology
ServicesDivisionwillbeavailabletohelpensurepolicies,designintentions(EA/SOA),
development,testingandimplementationareadheredtoaswellasalignedandintegratedwith
theExchangeprogramsfederalrequirements.
BusinessStaff:BusinessstafffromtheAuthorityorotherappropriateagencieswillbeavailable
fordesign,development,testing,andimplementationasrequestedintheVendorsproposal
andnegotiatedwiththeAuthority.

SECTION2
2 Schedule
ThisRFPisbeingissuedunderthefollowingSchedule.TheProposaldeadlinesaremandatoryandnon
negotiable.Failuretomeetanyoftherequireddeadlines(datesandtimes)willresultindisqualification
fromparticipation.
NOTE:AlltimesarePacificStandardTime
IssueRFP 10/28/2011
PreResponseConference 11/8/2011,9:00AMPST
VendorLetterofIntentDue 11/8/2011,3:00PMPST
VendorComplaintsRegardingRequirementsDue 11/16/2011,3:00PMPST
FinalVendorQuestionsDue 11/22/2011,3:00PMPST
PublishFinalQ&A 12/2/2011
VendorProposalsDue 12/8/2011,3:00PMPST
AdministrativeReview 12/9/201112/13/2011
WrittenProposalEvaluationPeriod 12/14/20111/9/2012
ScheduleOralPresentations/Demonstrations 1/10/2012
ConductVendorOralPresentations/Demonstrations 1/18/20121/20/2012
AnnounceApparentlySuccessfulVendor 1/25/2012
RequestforOptionalDebriefDue 1/27/2012,5:00PMPST
ConductOptionalDebriefs 1/30/20121/31/2012
ContractNegotiations 1/26/20122/7/2012
FileContractwithDES(10Businessdayfilingperiod) 2/8/2012
ContractExecuted 2/24/2012

HCAreservestherighttorevisetheaboveSchedule.
TheAuthorityrecognizesthatthisisanaggressivescheduleandexpectstheApparentlySuccessful
Vendor(ASV)tobepreparedforashortcontractnegotiationperiod.Failuretodosoputstheprojectat
riskofnotbeingabletomeetupcomingfederalmandatedmilestones,therebyriskingthelossoffederal
grantfunds

SECTION3
3 AdministrativeRequirements
3.1 RFPCoordinator(ProperCommunication)
UponreleaseofthisRFP,allVendorcommunicationsconcerningthissolicitationmustbedirectedtothe
RFPCoordinatorlistedbelow.WiththeexceptionoftheOfficeofMinorityandWomensBusiness
Enterprises,unauthorizedcontactregardingthissolicitationwithotherstateemployeesinvolvedwith
thesolicitationmayresultindisqualification.Proposalsshouldbebasedonthematerialcontainedin
theRFP,anyrelatedamendments/addenda,andanyquestionsandwrittenanswersdirectedthrough
theRFPCoordinator.AlloralcommunicationswillbeconsideredunofficialandnonbindingontheState.
VendorsshouldrelyonlyonwrittenstatementsissuedbytheRFPCoordinator.
JohnFlanagan,RFPCoordinator
HealthCareAuthority
Telephone:(360)9232697
FAX:(360)9232835
Email:mailto:Contracts@HCA.wa.gov
(PleaseincludeRFP#K521insubjectline)

USPSMail:
PostOfficeBox42702
Olympia,WA985042702
Foranyovernight,courier,handdelivery,etcofthebidsweneedtousethefollowingaddress:
Attn:JohnFlanagan
HealthCareAuthority
3819PacificAvenueSE,SuiteA
Lacey,WA98503
Forofficialcommunications,theAuthoritymayutilize:
USPSmail;
email;
theAuthoritysProcurementWebSite(http://www.hca.wa.gov/rfp.html);
WEBS(Washington'sElectronicBusinessSolutionresourcecenterforVendorslocatedat
https://fortress.wa.gov/ga/webs/)
3.2 ProcurementWebSiteandVendorReferenceLibrary
ThecontentsofthisRFP,andallrelateddocuments,alongwithanyamendments/addendaandwritten
answerstoquestionswillbeavailableontheHCAwebsiteat:http://www.hca.wa.gov/rfp.html
ThisLibraryincludessupportingdocumentsforthefollowing:
Business/FunctionalRequirements

o RequirementsMatrixcontainsthefunctionalrequirementsthatthevendorsproposal
mustrespondto.
o DocumentationProvidingContexttotheRequirementsThefollowingdocumentsare
providedasadditionalcontextinordertounderstandtheintentofrequirements.These
documentsdonotrepresentscopeandarenotfinalized,butareprovidedtoassistinscope
determinationandunderstandingtheAuthoritysintentfortherequirements.
9 BusinessProcessFlowDiagramsprovidesahighlevelindicationoftheAuthoritys
currentthinkingonprocessflowsforthefunctionalrequirements
9 BusinessProcessDescriptionsprovidesnarrativetosupportthebusinessprocessflow
diagrams,andcontextforthefunctionalrequirements
9 ObjectRoleModel(optional)providesaconceptualdataviewascontextfor
understandingthefunctionalrequirements.
9 SystemContextDiagram(optional)providesaconceptualsystemmodelshowing
actors,systemsandthedataflowingbetweenthesystems
ProjectManagementRequirements
o ExchangeRiskandIssueManagementPlan
o SampleStandardofPerformance
TechnologyRequirements
o TechnicalReferenceModel
o ExchangeSecurityBlueprint
CMSArtifactsDocumenttemplatesdefinedbyCMSforthedeliverablesnecessaryforthe
ExchangeStageGateReviewswhicharethebasisforVendordeliverableacceptance
CMSBlueprintsDocumentsprovidedbyCMSdescribingtheactivitiesrequiredoftheExchange
andofferingtechnicalguidance.
CMSNPRMsNoticeofProposedRuleMakingfortheExchange
Thedocument(s)willbeavailableinAdobeAcrobatorMicrosoftWordformats.Vendorsarestrongly
encouragedtovisittheWebSiteanddownloadthedocumentationfromtheLibrary.
3.3 (M)LetterofIntent;11/8/2011,3:00PMPST
AletterindicatingtheVendor'sintenttorespondtothisRFPmustbereceivedbytheRFPCoordinatorat
theaddressspecifiedinSection3.1:RFPCoordinator,nolaterthanthedateandtimelistedinSection2:
Schedule.TheVendormaysubmittheLetterofIntentbyUSPSmail,orcourier,oremail.Failureto
submitaLetterofIntentbythedeadlinespecifiedinSection2Schedule,willresultinVendor
disqualificationandtherejectionofanysubsequentProposal.
EachVendormustincludethefollowinginformationintheLetterofIntent:
a) NameofPrimeVendorOrganization;
b) NameofPrimeVendorRepresentativetoserveascontactforRFPcommunications;
c) PrimeVendorRepresentativeTitle;
d) PrimeVendorRepresentativeAddress;
e) PrimeVendorRepresentativeTelephoneNumber;
f) PrimeVendorRepresentativeFAXNumber;
g) PrimeVendorRepresentativeEmailAddress;
h) StatementofIntentandAvailability;
i) CertificationthatthePrimeVendormeetsorexceedstheminimumrequirementsofthisRFP;

j) StatementofVendorsgoodfaithbeliefinVendorsabilitytomeettheMandatoryandDesired
RequirementslistedinthisRFPdocument,andthoseinAppendicesB:ProjectManagement
Requirements,C:Business/FunctionalRequirements,andD:TechnologyRequirements;
k) Statementofcapacityandqualificationstoperformaprojectofscopeanddurationof
Exchange;
l) ListbynamethefirmsthatthePrimeVendoranticipatesusingassubcontractors;
m) Briefdescriptionofhowyourcompanymeetstheminimumqualificationssetoutinsection4.1:
MinimumQualifications.
3.4 (M)PreProposalConference;11/8/2011,9:00AMPST
VendorswhowishtosubmitaProposaltothisRFPmustparticipateinaMandatoryPreProposal
ConferenceonthedateandatthetimeidentifiedinSection2:Schedule.Vendorswhodonotattend
theConferencewillnotbeeligibletosubmitaProposaltotheRFP.TheConferencewillbeheldatthe
followinglocation:
HealthBenefitsExchangePreProposalConference
GeneralAdministrationBuilding
1STFloor;Auditorium
21011thAvenueSW
Olympia,WA98501
http://www.ga.wa.gov/Park/visitor.htm

ThepurposeofthisPreProposalConferenceistoprovideVendorsanopportunitytoaddressquestions
theymayhaveconcerningtheRFP.Vendorsarerequestedtosubmittheirquestionsinwritingtothe
RFPCoordinatorattheirearliestopportunitypriortothePreProposalConference.Verbalanswersto
additionalVendorquestionsatthetimeofthePreProposalConferencewillbenonbindingand
unofficial.TheAuthoritywillattempttoprovideawrittenresponsetosignificantquestionsto
participatingVendorswithinthree(3)BusinessDaysafterthePreProposalConference.
AttendanceatthePreProposalConferenceismandatory.Participationbyteleconferencewillnotbe
allowed.AttendanceatthePreProposalConferenceisattheVendorssoleexpense.
WearealsopursuingconductingthisviaaWebExconferenceandthusavoidingthenecessityto
conductthisatonephysicallocation.Furtherdetailswillfollow;however,untilfurthernotice
attendanceinpersonisstillmandatory.
3.5 VendorQuestions
VendorquestionsregardingthisRFPwillbeaccepteduntilthedatesandtimesspecifiedinRFPSection
2:Schedule.Earlysubmissionofquestionsisencouraged.Vendorquestionsmustbesubmittedin
writingviaemailtotheRFPCoordinatoratcontracts@hca.wa.gov.Anofficialwrittenresponsewillbe
providedforVendorquestionsreceivedbythedeadlinesintheSchedule,Section2above.
WrittenresponsestoVendorquestionswillbepostedontheAuthoritysProcurementWebSiteat:
http://www.hca.wa.gov/rfp.html.TheVendorthatsubmittedthequestionswillnotbeidentified.
VerbalresponsestoquestionswillbenonbindingontheAuthority.Onlywrittenresponsespostedto
theAuthoritysProcurementWebSitewillbeconsideredofficialandbinding.
Vendorsarerequestedtousethefollowingformatwhensubmittingtheirwrittenquestions

Question Document Section# Pageor Question Response
# Name andTitle Paragraph#

3.6 VendorComplaintsRegardingRequirementsandSpecifications
VendorsareencouragedtoreviewtheMandatoryRequirementsofthisRFPcarefully.IfVendor
believesthatthedocumentundulyconstrainscompetitionorcontainsinadequateorimpropercriteria,
acomplaintmaybemadetotheRFPCoordinatorbeforeavendorrespondstoasolicitationdocument.
WhereMandatoryRequirementsappeartoprohibitorrestrictyourfirmsparticipation,anexplanation
oftheissuewithsuggestedalternativelanguageshouldbesubmittedinwritingtotheRFPCoordinator
bythedeadlineforVendorCommentsandComplaintsinSection2:Schedule.
Vendorsareexpectedtoraiseanyquestions,exceptions,oradditionstheyhaveconcerningtheRFP
requirementsearlyintheRFPprocess.Thesolicitationprocessmaycontinue.
TheAuthoritywillimmediatelyforwardacopyofthecomplainttotheDepartmentofEnterprise
Services(DES)andtheOfficeofChiefInformationOfficer(OCIO)TheAuthoritywillalsoreplytothe
VendorwithaproposedsolutionandadviseDESandOCIOofitsreply.IftheVendorrejectsthe
Authoritysproposedsolution,DESmaydirectmodificationofsolicitationrequirementsortheschedule,
directwithdrawalofthesolicitation,ormaytakeotherstepsthatitfindsappropriate.TheDESdecision
isfinal;nofurtheradministrativeappealisavailable.
3.7 (M)ProposalContents
TheProposalmustcontaininformationrespondingtoallMandatoryRequirementsintheRFP
document,andRFPAppendicesB:ProjectManagementRequirements,C:Business/Functional
Requirements,D:TechnologyRequirements,P:EligibilityServiceRequirements;andmustincludethe
signatureofanauthorizedVendorrepresentativeonalldocumentsrequiredintheAppendices.
AppendicesA,B,C,DandPareanextensiontoRFPSections4and5.Specifically:
AppendixAissupplementaltoSubsection4.4
AppendixBissupplementaltoSubsection5.2;
AppendicesCandPissupplementaltoSubsection5.3,and;
AppendixDissupplementaltoSubsection5.4.
VendorsproposalsmustrespondtoallquestionsinboththisRFPdocumentandappendicesA,B,C,D,
E,KandP.
TheProposalmustbesubmittedinthree(3)volumesorganizedandcontainingtheinformationlisted
below.ThisseparationofdocumentationprotectstheintegrityoftheStatesevaluationprocess.No
mentionoftheFinancialProposalmaybemadeinVolumes1or3.
Volume1:
VendorsLetterofSubmittal(Section4.2Error!Referencesourcenotfound.:Vendor
Profile/LetterofSubmittal)explicitlyacknowledgingreceiptofallRFPamendments/addenda
issued.

TheResponsetoSections4and5
TheResponsetoAppendixA:VendorOrganizationalCapabilitiesRequirements
TheResponsetoAppendixB:ProjectManagementRequirements
TheResponsetoAppendixC:Business/FunctionalRequirements
TheResponsetoAppendixD:TechnologyRequirements
TheResponsetoAppendixP:EligibilityServiceRequirements

Volume2:
FinancialProposal(Section6:FinancialProposal)
Volume3
VendorssignedandcompletedCertificationsandAssurances(AppendixE)
Vendorsexceptionsand/orproposedrevisionstotheContract(AppendixF)
SoftwareLicensingtermsforanyproposedsoftwarethatisnotownedbyVendor(seeSection
4.4)
VendorsMinorityandWomensBusinessEnterprise(MWBE)Certification(AppendixG,if
applicable)

3.8 (M)NumberofProposalCopiesRequired
1CDROMofProposalVolume1,withone(1)trueandcorrectprintedoriginal,plusfour(4)
completeprintedcopies,producedon8.5x11paper,punchedandboundinseparatethreering
binders(Note:morethanasinglebindermayberequiredforVolume1).
binders.
binders.
1copyofmanuals,brochures,orotherprintedmaterials,ifsubmitted,includingany
demonstrationvideoordemonstrationwebsiteonCDROM.
3.9 (M)ProposalPresentationandFormatRequirements
ThefollowingrequirementsareMandatoryinrespondingtothisRFP.Failuretofollowthese
requirementsmayresultinVendordisqualification.
3.9.1 ThesignatureblockinAppendixE:CertificationsandAssurancesmustbesignedbya
representativeauthorizedtobindthecompanytotheoffer.
3.9.2 VendormustrespondtoeachrequirementcontainedinAppendixA:VendorOrganizational
Capabilities,AppendixB:ProjectManagementRequirements,AppendixC:Business/Functional
Requirements,AppendixD:TechnologyRequirements,AppendixP:EligibilityService
Requirements,AppendixK:FinancialResponseandcompleteSection6:FinancialProposal,and
completeAppendixE:CertificationsandAssurances.
3.9.3 FailuretosubmitanyoftherequireddocumentsmayresultintheProposalbeingdisqualified.

3.9.4 EachoftheRFPrequirementsarenumberedandtitled.Ineachrequirementtitleisa
designationindicatinghowtheProposalwillbeevaluated:
a) ForMandatoryRequirements(M),theProposalmustalwaysindicateexplicitlywhetheror
nottheVendorsproposedservicesmeettherequirement.Astatement,(VendorName)
hasread,understands,andfullycomplieswiththisrequirementisacceptable,alongwith
anyadditionalinformationrequested.
b) ForMandatoryScoredrequirements(MS)andDesirableScored(DS)requirementsitems,
theProposalmustalwaysindicateexplicitlywhetherornottheVendor'sproposedservices
meettherequirement,anddescribehowtheVendorsproposedserviceswillaccomplish
eachrequirementoraredesirableasitrelatestotheservice(s)proposed.
3.9.5 Proposalsmustbepreparedonstandard8.5x11inchlooseleafpaperandplacedinthreering
binderswithtabsseparatingthemajorsectionsoftheProposal.Pagesmustbenumbered
consecutivelywithineachsectionoftheProposalshowingProposalsectionnumberandpage
number.Responsestonumberedrequirementsmustincludetherequirementnumber.Font
sizemustbe11orlarger.Vendormayincludeoversizeinsertsintheirsubmission.
3.9.6 IncludeVendornameandthename,address,email,facsimileandtelephonenumberofthe
VendorsauthorizedrepresentativeatthebeginningofeachvolumeoftheProposal.
3.9.7 FiguresandtablesmustbenumberedandreferencedinthetextoftheProposalbythat
number.Foldoutscontainingcharts,spreadsheets,andoversizeexhibitsarepermissible.
3.9.8 TheProposal,aswellasanyreferencematerialspresentedbyVendor,mustbewrittenin
EnglishandVendormustprovideallratesinUnitedStatesdollars.
3.9.9 FilessubmittedonCDROMsmustbeinMSWord,MSExcel,MSVisio,MSProjectorAdobe
Acrobatformat.Filesmustnotbelockedorprotected.Failuretoprovideanyrequested
informationintheprescribedformatmayresultindisqualificationoftheVendor.
3.10 (M)DeliveryofProposals
ItisMandatorythatVendorssubmitallcopiesoftheirProposalsbythedateandtimeinSection2:
Schedule,totheRFPCoordinatorattheaddressspecifiedinSection3.1:RFPCoordinator.
ProposalsmustbereceivedattheAuthoritybythedateandtimespecified.Proposalsarrivingafterthe
deadlinewillbereturnedunopenedtotheirsenders.Apostmarkbythattimeisnotacceptable.
Proposalssentbyfacsimileoremailwillnotbeaccepted.Vendorsassumeallresponsibilityforthe
methodofdeliveryandforanydelayinthedeliveryoftheirProposal.
3.11 CostofProposalPreparation
TheAuthoritywillnotreimburseVendorsforanycostsassociatedwithpreparingorpresentinga
ProposaltothisRFP.
3.12 ProposalPropertyoftheAuthority
AllmaterialssubmittedinresponsetothissolicitationbecomethepropertyoftheAuthority,unless
receivedafterthedeadlineinwhichcasetheProposalisreturnedtothesender.TheAuthorityhasthe
righttouseanyoftheideaspresentedinanymaterialoffered.SelectionorrejectionofaProposaldoes
notaffectthisright.

3.13 ProprietaryorConfidentialInformation
TheAuthorityissubjecttothePublicRecordsAct(chapter42.56RCW).VendorsResponsecanbe
disclosedthroughtheprocesssetforthinthissection.PortionsofVendorsResponsemaybeprotected
fromdisclosurethroughtheprocesssetforthinthissection.
VendorcannotrestrictitsentireResponseorentiresectionsoftheResponsefromdisclosure.
Vendorcannotrestrictitspricingfromdisclosure
Anyattemptstorestrictdisclosurethroughuseoffootersoneverypageand/orstatementsrestricting
disclosurewillnotbehonoredandmaysubjectVendortodisqualification.
IfVendorwantstoprotectanyProprietaryInformationthatisincludedinitsResponsefromdisclosure,
theinformationmustbeclearlyidentifiedbyVendorasProprietaryInformation.Vendormustidentify
sectionsorpagesclaimedasproprietaryinitsLetterofSubmittal(Section4.2:VendorProfile/Letterof
Submittal).ProprietaryInformationisdefinedasinformationownedbyVendortowhichVendor
claimsaprotectableinterestunderlaw.ProprietaryInformationincludes,butisnotlimitedto,
informationprotectedbycopyright,patent,trademark,ortradesecretlaws.
TheAuthoritywillmaintaintheconfidentialityofallinformationmarkedProprietaryInformationtothe
extentconsistentwiththePublicRecordsAct.IfapublicdisclosurerequestismadetoviewVendors
ProprietaryInformation,theAuthoritywillnotifyVendoroftherequestandofthedatethatthe
ProprietaryInformationwillbereleasedtotherequesterunlessVendorobtainsacourtorderfroma
courtofcompetentjurisdictionenjoiningthatdisclosure.IfVendorfailstoobtainthecourtorder
enjoiningdisclosure,theAuthoritywillreleasetheProprietaryInformation,onthedatespecified.
TheAuthorityssoleresponsibilityshallbelimitedtomaintainingVendorsidentifiedProprietary
InformationinasecureareaandtonotifyVendorofanyrequest(s)fordisclosureforsolongasthe
AuthorityretainsVendorsinformationintheAuthoritysrecords.Failuretosolabelsuchmaterialsor
failuretotimelyrespondafternoticeofrequestforpublicdisclosurehasbeengivenshallbedeemeda
waiverbyVendorofanyclaimthatsuchmaterialsareexemptfromdisclosure.
3.14 WaiveMinorAdministrativeIrregularities
TheAuthorityreservestherighttowaiveminoradministrativeirregularitiescontainedinanyProposal.
Additionally,theAuthorityreservestheright,atitssoleoption,tomakecorrectionstoVendors
Proposalswhenanobviousarithmeticalerrorhasbeenmadeinthepricequotation.Vendorswillnotbe
allowedtomakechangestotheirquotedpriceaftertheProposalsubmissiondeadline.
3.15 ErrorsinProposal
VendorsareliableforallerrorsoromissionscontainedintheirProposals.Vendorswillnotbeallowedto
alterProposaldocumentsafterthedeadlineforProposalsubmission.TheAuthorityisnotliableforany
errorsinProposals.TheAuthorityreservestherighttocontactVendorforclarificationofProposal
contents.
Inthosecaseswhereitisuncleartowhatextentarequirementorpricehasbeenaddressed,the
evaluationteam(s)may,attheirdiscretionandactingthroughtheRFPCoordinator,contactaVendorto
clarifyspecificpointsinthesubmittedProposal.However,undernocircumstanceswilltheresponding
Vendorbeallowedtomakechangestotheproposeditemsafterthedeadlinestatedforreceiptof
Proposals.

3.16 Amendments/Addenda
TheAuthorityreservestherighttoamendportionsofthisRFPatanytime.TheAuthoritymaycorrect
errorsinthesolicitationdocumentidentifiedbytheAuthorityoraVendor.Anychangesorcorrections
willbebyoneormorewrittenamendment(s),dated,andattachedtoorincorporatedinandmadea
partofthissolicitationdocument.AllchangesmustbeauthorizedandissuedinwritingbytheRFP
Coordinator.Ifthereisanyconflictbetweenamendments/addenda,orbetweenanamendmentandthe
RFP,whicheverdocumentwasissuedlastintimeshallbecontrolling.Intheeventthatitisnecessaryto
reviseorcorrectanyportionoftheRFP,anoticewillbepostedontheAuthoritysProcurementWeb
Siteat:http://www.hca.wa.gov/rfp.html.
3.17 RighttoCancel
WithrespecttoallorpartofthisRFP,theAuthorityreservestherighttocancelorreissueatanytime
withoutobligationorliability.
3.18 ContractRequirements
TheAuthoritysProposedContract,basedontheModelInformationTechnologyContractTermsand
ConditionsadoptedbytheOCIO,hasbeenincludedasAppendixF.
Toberesponsive,VendorsmustindicateawillingnesstoenterintoaContractsubstantiallysimilarto
theAuthoritysproposedcontract,bysigningtheCertificationsandAssuranceslocatedinAppendixE.
AnyspecificareasofdisputewiththeattachedtermsandconditionsmustbeidentifiedintheProposal
andmay,atthesolediscretionoftheAuthority,begroundsfordisqualificationfromfurther
considerationintheawardofaContract.
AVendorwillbemorefavorablyevaluatedbasedonthedegreeofacceptanceofthespecifiedterms
andconditionswithoutexception,reservation,orlimitation.
Vendorsmay,however,proposerevisionstotheProposedContractterminologyforclarificationand
proceduralpurposes,and/orrevisionsbaseduponspecificelementsoftheirproposedsolution.
UndernocircumstancesisaVendortosubmittheirownstandardcontracttermsandconditionsasa
responsetothissolicitation.Instead,VendormustreviewandidentifythelanguageinAppendixFthat
Vendorfindsproblematic,statetheissue,andproposethelanguageorcontractmodificationVendoris
requesting.AllofVendorsexceptionstothecontracttermsandconditionsinAppendixFmustbe
submittedwithintheProposal,attachedtoAppendixE:CertificationandAssurances.TheAuthority
expectsthefinalContractsignedbytheASVtobesubstantiallythesameastheContractlocatedin
AppendixF.
Theforegoingshouldnotbeinterpretedtoprohibiteitherpartyfromproposingadditionalcontract
termsandconditionsduringnegotiationofthefinalContract.
TheASVisexpectedtoexecutetheContractwithinten(10)BusinessDaysofitsreceiptofthefinal
Contract.IftheselectedVendorfailstosigntheContractwithintheallottedtimeframe,theAuthority
mayelecttocanceltheaward,andawardtheContracttothenextrankedVendor,orcancelorreissue
thissolicitation(Section3.17:RighttoCancel).VendorssubmissionofaProposaltothissolicitation
constitutesacceptanceofthesecontractrequirements.
TheagreeduponcontractissubjecttoStateandfederalapproval.
3.19 IncorporationofDocumentsintoContract
ThissolicitationdocumentandtheProposalwillbeincorporatedintoanyresultingContract.

3.20 BestandFinalOffer
UponcompletionoftheVendorsoralpresentationsanddemonstrations,theRFPCoordinatormay
issuetotheVendorsparticipatinginthepresentations/demonstrationsarequestforBestandFinal
Offers.ThisrequestmayincludespecificinstructionsastothecontentandformoftheBestandFinal
Offerandaninvitationtosubmitarevisedproposal.
TheStatereservestherighttoselecttheApparentlySuccessfulVendorwithoutrequestingaBestand
FinalOffer.Therefore,VendorsshouldsubmittheirproposalonthemostfavorabletermstheVendor
canoffer.
3.21 NoCostsorCharges
NocostsorchargesundertheproposedContractmaybeincurredbeforetheContractisfullyexecuted.
3.22 MinorityandWomensBusinessEnterprises(MWBE)
InaccordancewiththelegislativefindingsandpoliciessetforthinRCW39.19,theAuthorityencourages
participationinallofitsContractsbyMinorityandWomanOwnedBusinessEnterprise(MWBE)firms
eitherselfidentifiedorcertifiedbytheOfficeofMinorityandWomensBusinessEnterprises(OMWBE).
ParticipationmaybeeitheronadirectbasisinresponsetothisSolicitationorasaSubcontractortoa
Vendor.WhiletheAuthoritydoesnotgivepreferentialtreatment,itdoesseekequitablerepresentation
fromtheminorityandwomensbusinesscommunity.VendorswhoareMWBEorintendtouseMWBE
SubcontractorsareencouragedtoidentifytheparticipatingfirmonAppendixG:OMWBECertification.
Forquestionsregardingtheabove,ortoobtaininformationoncertifiedfirmsforpotentialsub
contractingarrangements,contactOfficeofMWBEat(360)7539693.
3.23 NoObligationtoContract/Buy
TheAuthorityreservestherighttorefrainfromContractingwithanyandallVendors.Neitherthe
releaseofthissolicitationdocumentnortheexecutionofaresultingContractobligatestheAuthorityto
makeanypurchases.
3.24 NonEndorsementandPublicity
InselectingaVendortosupplyservicestothestateofWashington,theStateisneitherendorsing
Vendorsproductsorservices,norsuggestingthattheyarethebestoronlysolutiontotheStates
needs.BysubmittingaProposal,VendoragreestomakenoreferencetotheAuthorityorthestateof
Washingtoninanyliterature,promotionalmaterial,brochures,salespresentationorthelike,regardless
ofmethodofdistribution,withoutthepriorreviewandexpresswrittenconsentoftheAuthority.
3.25 WithdrawalofProposal
VendorsmaywithdrawaProposalthathasbeensubmittedatanytimeuptotheProposalduedateand
time(identifiedinSection2:Schedule).ToaccomplishProposalwithdrawal,awrittenrequestsignedby
anauthorizedrepresentativeofVendormustbesubmittedtotheRFPCoordinator.Afterwithdrawinga
previouslysubmittedProposal,VendormaysubmitanotherProposalatanytimeuptotheProposal
submissionduedateandtime.
3.26 OptionalVendorDebriefing
OnlyVendorswhosubmitaProposalmayrequestanoptionaldebriefingconferencetodiscussthe
evaluationoftheirProposal.Therequesteddebriefingconferencemustoccuronorbeforethedate

specifiedinSection2:Schedule.Therequestmustbeinwriting(emailacceptable)addressedtotheRFP
Coordinator.
TheoptionaldebriefingwillnotincludeanycomparisonbetweenVendorsProposalandanyother
Proposalssubmitted.However,theAuthoritywilldiscussthefactorsconsideredintheevaluationofthe
requestingVendorsProposalandaddressquestionsandconcernsaboutVendorsperformancewith
regardtothesolicitationrequirements.Thedebriefingconferencemaytakeplaceinpersonorby
telephone.
3.27 ProtestProcedures
VendorswhohavesubmittedaProposaltothissolicitationandhavehadadebriefingconferencemay
makeprotests.Uponcompletionofthedebriefingconference,aVendorisallowedfive(5)Business
DaystofileaformalprotestofthesolicitationwiththeRFPCoordinator.Furtherinformationregarding
thegroundsforfilingandresolutionofprotestsiscontainedinAppendixH:ProtestProcedures.
3.28 SelectionofApparentlySuccessfulVendor
AllVendorsrespondingtothisRFPshallbenotifiedbymailoremailwhentheAuthorityhas
determinedthefinalist.Thedateoftheannouncementofthefinalistshallbethedatethe
announcementispostmarked.
OnefinalistwillbeselectedastheASV.TheASVwillbetheVendorwho:(1)meetsalltherequirements
ofthisRFP;and(2)receivesthehighestrankingasdescribedinSection7:EvaluationProcess.


SECTION4
4 VENDORREQUIREMENTS
RespondtothefollowingVendorRequirementsinSection4aswellasthesupplementalVendor
RequirementsinAppendixA:VendorOrganizationalCapabilitiesRequirements,pertheinstructionsin
Section3.9:ProposalPresentationandFormatRequirements.
4.1 (M)VendorMinimumQualifications
Vendorsmustmeetthefollowingminimumqualifications:
a) VendormustbelicensedtodobusinessintheStateofWashingtonorprovideacommitment
thatitwillbecomelicensedinWashingtonwithinthirty(30)calendardaysofbeingselectedas
theApparentlySuccessfulVendor(ASV).
b) Vendormusthaveexperiencedesigning,developingandimplementingahealthrelatedsystem
(e.g.,eligibility,enrollments,benefits,insurance,claims)inthelastfive(5)yearsofsimilarsize
andcomplexityandwithacontractvalueinexcessof$15millionORmustprovidepersuasive
rationalewhyyourorganizationisqualifiedtodevelopaHealthBenefitsExchange.
c) VendormusthaveagoodorbetterfinancialstrengthratingonaDunandBradstreet
business/creditreportofVendorsfinancialstatusdatednotmorethansixty(60)dayspriorto
thesubmittaldateoftheproposal.
4.2 (M)VendorProfile/LetterofSubmittal
VendormustprovideaLetterofSubmittalwrittenontheVendor'sofficialbusinessletterhead
stationerythatmustbeincludedinVolume1ofVendorsResponse(Section3.7:ProposalContents)
andmustinclude:
a) Thelegalbusinessname;
b) Typeofbusinessentity,(e.g.,corporation,soleproprietorship,limitedliabilitycompany.);
c) Theyeartheentitywasorganizedtodobusinessastheentitynowsubstantiallyexists;
d) WashingtonStateUniformBusinessIdentification(UBI)number,ifregistered;
e) ProposalPrimaryContactaddress,emailaddress,telephoneandFAXnumbers;
f) AwebsiteURL(ifany);
g) AnorganizationalchartofVendorsprincipalofficers,includingnamesandtitles;
h) AstatementthattheVendormeetsalltheminimumqualificationsandthattheproposed
solutionmeetsalltheMandatory(M)andMandatoryScored(MS)Requirementssetforthin
theRFPanditsamendments/addenda,ifany;
i) IdentificationofsectionsorpagesofVendorsProposalclaimedasProprietary(seeSection3.13
ProprietaryInformation);
j) AstatementthatacknowledgesandagreestoalloftherightsofHCAincludingtheRFPrulesand
proceduresandthetermsandconditionsofthisRFP,includinganyamendments/addenda;
k) AreferencetoallRFPamendments/addendareceivedbytheVendor(identifiedbyamendment
issuedate)torepresentthattheVendorisawareofallsuchamendments/addenda.IfnoRFP
amendments/addendahavebeenreceived,theVendorshouldsostate;
l) Anyotherrepresentations,assurancesorwarrantiesthattheVendordeemsappropriateand
wishestoconveytoHCA.
TheLetterofSubmittalmustbesignedanddatedbyanindividualwithfullauthoritytolegallybind
theentitysubmittingtheProposaltothisRFP.

4.3 (M)ExecutiveSummary
The Vendors proposal must summarize the proposed project management approach and overall
services,givingtheevaluatorsastronggeneraloverviewoftheOrganizational,Management,Technical,
andFunctionalproposalsoftheVendor.
TheVendorsproposalmust:
StatetheVendorsabilityandwillingnesstoworkcooperativelywithHCAanddesignees.
StatethattheVendoragreestocomplywiththeprocurementprocessdescribedintheRFP.
StatethattheVendorunderstandsthescopeandobjectivesoftheprojectandagreestomeet
therequirementsspecifiedintheRFP.
StatethattheVendorwillperformtheservicesdescribedintheRFP.
StatethattheVendorsproposedsolutionwillmeetallWashingtonStateHealthBenefits
(Insurance)ExchangeExchangerequirements.
Identifyanyoperationalissues.
IdentifyanyuniqueorinnovativefeaturesofVendorsproposedsolution.
Provideanoverviewoftherisksassociatedwiththisproject,criticalsuccessfactors,andactions
HCAshouldconsiderduringthemajorExchangeprojectstages.
ExplainhowtheproposedsolutionrepresentstoHCAthebestoptionforitsHealthBenefits
(Insurance)Exchangeproject,andwhyHCAshouldselecttheproposedsolution.
4.4 (M)SoftwareOwnership
IfVendorisproposingaSoftwareBasedSolution,VendorsResponsemustincludeastatement
indicatingwhethertheSoftwareisownedbyVendororathirdparty.IftheVendorisnotthe
owneroftheSoftware,VendormustagreetothefollowingforeachSoftwareproductincluded
inVendorsproposedsolution(pleaseindicatewhetherVendorunderstandsandagreestoeach
failuretodosowillresultindisqualificationfrombiddingonthisRFP):
a) VendormustidentifytheSoftwareownerandprovidecontactinformation;and
b) VendormustprovidetheSoftwareownerslicensingtermsinVolume3ofthe
Response;and
c) VendormustprovideHCAstermsandconditions(AppendixF)tosoftwareowner;and
d) SoftwareownermustagreetoparticipateincontractnegotiationswithHCA.
4.5 (M)SinglePointofContact
VendorwillactastheSinglePointofContactfortheAuthoritywiththeVendorssubcontractors,
Productmanufacturers,andotherrelevantthirdpartiesfortheServicesdescribedintheRequestfor
Proposal(RFP).

4.6 (M)VendorOrganizationalCapabilities
VendormustprovidearesponsetotherequirementsincludedinthedocumentAppendixA:Vendor
OrganizationalCapabilitiesRequirementsattachedwiththisRFP.Vendorsmustrespondwithinthe
appendix.
4.7 (M)VendorAccountManager
VendorshallappointanAccountManagerwhowillprovideoversightofVendorContractactivities
undertheContractresultingfromthisRFP.VendorsAccountManagerwillbetheprincipalpointof
contactconcerningVendorsContractperformance.
4.8 (MS)ClientReferences
4.8.1 (M)VendormustensurethatonorbeforethedateandtimetheProposalsaredue(Section2:
Schedule)theRFPCoordinatorreceivesatleastthree(3)andnomorethansix(6)client
references(AppendixJ)fromcustomersforwhomtheVendorhasimplementedsystemssimilar
insizeandscope.
AtleastonereferencemustbefromacustomerforwhomVendoractedasthe
integratorforalarge(e.g.$15Mormore)healthrelatedproject(e.g.,eligibility,
enrollments,benefits,insurance,claims).
AtleasttworeferencesmustbeforasystemimplementationonwhichVendorwasthe
primecontractor.
Referencesmustnotbefromaperson,companyororganizationwithanyinterest,
financialorotherwise,intheVendororganization.Referencesthatdonotoriginate
fromaClientinanarmslengthrelationshipwithVendorwillberejected.

Themostrelevantreferencesareconsideredthosethatthevendorhasprovidedservicessimilar
intypeandscopetothoserequestedwithinthisRFP,RFPK521.
HCAreservestherighttobeoneofVendorsclientreferencesbasedonHCAspriorexperience
withVendor,andhaveHCAsClientReferenceFormevaluated.
4.8.2 (M)TheVendorisresponsibleforprovidingtheClientReferenceFormtotheiridentified
customerreferences(seeAppendixJ:ClientReferenceForm).VendorshouldselectClient
Referencesthatwillrespondinatimelymanner.EachClientReferencemustcompletethe
ClientReferenceFormandeithermailtheoriginalsignedcopyoremailorFAXaPDFofasigned
copydirectlytotheRFPCoordinator.ThecompletedClientReferenceFormmustbereturned
directlyfromthecustomer,nottheVendor.AllformsmustbereceivedbytheRFPCoordinator
nolaterthanthetimeanddateindicatedintheSchedule(Section2,Schedule).
4.8.3 (M)IftheClientReferenceFormsarenotreceivedbytheRFPCoordinatoronorbeforethe
indicateddateandtime,HCAwillmakeoneattempttocontacttheClientreferenceslistedin
VendorsresponsetoSubsection4.8.4toobtainacompletedClientReferenceForm.Ifcontact
cannotbemadewithinonebusinessdayorthereferencedeclinestosubmittheClient
ReferenceForm,thatClientReferencewillnotbeincludedintheevaluation.
4.8.4 (M)Vendormustprovidethefollowinginformationabouteachcustomerreference.
1. OrganizationName;
1. TypeofBusiness
2. Contactnameandtitle;

3. TelephoneandEmailaddress;
4. Abriefdescriptionoftheworkdoneforthereferencedclient;
5. Startandenddates;anddollaramountofproject;and
6. DateofsystemacceptancebytheClient
4.8.5 (M)HCAmayeliminatefromcontractawardconsiderationanyVendorwhoreceivesan
unfavorablereportfromaVendoridentifiedcustomerreference.HCAalsoreservestherightto
contactotherVendorcustomersforadditionalreferences.
4.9 (M)IntellectualProperty
ExceptasexpresslyprovidedintheContractresultingfromthisRFP,VendoragreesthatallSoftwareand
documentsthataredevelopedasaparttheProjectwillbecomeofthepropertyoftheStateof
Washington,HealthCareAuthority.
4.10 (M)FinancialRating
VendormustprovideacopyofaDunandBradstreetbusiness/creditreportoftheVendorsfinancial
statusdatednotmorethansixty(60)dayspriortothesubmittaldateoftheproposalthatindicatesa
financialstrengthratingofgoodorbetter..
4.11 (M)VendorLicensedtodoBusinessinWashington
Withinthirty(30)daysofbeingidentifiedastheASV,Vendormustbelicensedtoconductbusinessin
Washington.TheVendormustcollectandreportallapplicabletaxes.Inordertoreceivepaymentfrom
Washingtonstateagencies,ContractorsmustberegisteredintheStatewideVendorPayment
RegistrationsystemmaintainedbytheOfficeofFinancialManagement.Toobtainregistrationmaterials
gotohttp://www.ofm.wa.gov/isd/vendors.asp.
4.12 (M)UseofSubcontractors
TheAuthoritywillacceptProposalsthatincludethirdpartyinvolvementonlyiftheVendorsubmitting
theProposalagreestotakecompleteresponsibilityforallactionsofsuchSubcontractors.Vendorsmust
statewhetherSubcontractorsare/arenotbeingused,andiftheyarebeingused,Vendormustlistthem
inresponsetothisSection.AnySubcontractorsengagedafterawardoftheContractmustbepre
approved,inwriting,bytheAuthority.
SpecificrestrictionsapplytocontractingwithcurrentorformerstateemployeespursuanttoChapter
42.52RCW.Vendorsshouldfamiliarizethemselveswiththerequirementspriortosubmittinga
Proposal.
4.13 (M)PriorContractPerformance
TheVendorsproposalmustrespondtothefollowing:
4.13.1 VendormustsubmitfulldetailsofallContractswiththeStateofWashingtonwithinthelast
eight(8)years,includingtheotherpartysname,address,emailaddressandtelephonenumber.
4.13.2 Vendormustsubmitabriefdescriptionofanysignificantpendinglegalandadministrative
proceedingsinanyjurisdictioninwhichVendor,itsofficers,directors,employeesorprincipalsor
anyofitssubsidiariesorparent(s),theirofficers,directors,employeesorprincipalsisapartyor
ofwhichanyoftheirpropertyissubject.Includethenameofthecourtoragencyinwhichthe
proceedingsarepending,thedateinstituted,andtheprincipalpartiesthereto,andadescription
ofthefactualbasisallegedtounderlietheproceedings.Notwithstandingtheforegoing,Vendor

shallsubmitinformationconcerninganyclaimorallegationwhichbringsintoquestionVendors
performanceorfailuretoperform.
4.13.3 VendormustsubmitabriefdescriptionofanyoccasioninwhichVendor,anyofficerorprincipal
ofVendorwithaproprietaryinteresttherein,haseverbeendisqualified,removedorotherwise
preventedfrombiddingon,participatingin,orcompletingafederal,stateorlocalgovernmental
projectbecauseofaviolationoflaworasafetyregulation.
4.13.4 VendormustsubmitabriefdescriptionofanyoccasioninwhichVendorhasbeeninaposition
ofdefaultonaproject,suchthatpaymentproceedingsand/orexecutiononaletterofcredit,
payment,performanceorbidbondhavebeenundertaken.
4.13.5 Vendormustsubmitalistofallmaterialthreatenedand/orpendingclaims,litigationand
judgmentsorsettlements,governmentenforcementactions.
4.13.6 VendormustidentifywhethertheVendororanyofitsofficersrefusedtotestifyorwaive
immunitybeforeanystateofthefederalgrandjuryrelatingtoanypublicprojectwithinthelast
tenyears.Ifso,providedetails.
4.13.7 Ifmultipleorganizationsareparticipating(e.g.,subsidiaries,parentcompanies,and/or
subcontractors),theinformationrequestedhereinmustbeprovidedregardingeachofthe
respectiveorganizations.
4.13.8 TheAuthoritywillevaluatetheinformationandmay,atitssolediscretion,rejecttheProposalif
theinformationindicatesthatcompletionofaContractresultingfromthisRFPmaybe
jeopardizedbyselectionoftheVendor.
4.14 (M)LetterofCredit
Within10daysofexecutingtheContract,VendormustprovideHCAwithanIrrevocableLetterofCredit,
namingHCAasthebeneficiary,inaformandformatacceptabletoHCAinanamountof$5Million.
IrrevocableLetterofCredit(theILC)meansawrittencommitmentbyafederallyinsuredfinancial
institutiontopayallorpartofastatedamountofmoney,untiltheexpirationdateoftheletter,upon
presentationbyHCA(theBeneficiary)ofawrittendemandtherefore.Neitherthefinancialinstitution
northeVendormayrevokeorconditiontheLetterofCredit.TheILCsecuringVendorsperformanceof
itsContractobligationsandotherpotentialliabilitiestoHCAmustremainineffectuntiltheendofthe
WarrantyPeriod.
4.15 (M)Insurance
TheASVwillberequiredtoobtaininsurancetoprotecttheStateshouldtherebeanyclaims,suits,
actions,costs,ordamagesorexpensesarisingfromanynegligentorintentionalactoromissionofthe
VendororitsSubcontractor(s),ortheiragents,whileperformingworkunderthetermsofanyContract
resultingfromthissolicitation.Vendorswillfindacompletedescriptionofthespecificinsurance
requirementsintheproposedcontracttermsinAppendixF:ProposedContract.
4.16 (M)LocationofVendorsProjectDevelopmentTeam
TheVendorsExchangeprojectdevelopmentteamwillbebasedintheExchangeProjectFacility,in
Olympia,WashingtonwithinreasonableproximitytotheAuthoritysCherryStreetPlazaoffices:
WashingtonStateHealthCareAuthority
6268thAve.
Olympia,WA98504

SECTION5
5 HealthBenefits(Insurance)ExchangeSystemRequirements
RespondtothefollowingVendorRequirementsinSection5aswellasthesupplementalVendor
RequirementsinAppendixB,CD,andPpertheinstructionsinSection3.9:ProposalPresentationand
FormatRequirements.
5.1 (M)RiskManagement
RiskManagementwillprimarilybetheresponsibilityoftheAuthoritysProjectTeamandExternal
QualityAssuranceContractor.Nevertheless,Vendorwillbeexpectedtoidentifyandmanageriskswithin
itsProjectManagementresponsibilitiesincoordinationwiththeAuthoritysProjectManagementTeam,
including:
a. Identificationofriskareas;
b. Classifyingcriticalityandprobabilityofoccurrence;
c. Planningpotentialcontingencymeasures;
d. Identifyingtriggerstoinitiatecontingencymeasures;and
e. Identificationandmonitoringofmitigationactivities.
VendormustagreetocooperateandworkwithHCAsQualityAssurance(QA)and,potentially,
IndependentValidationandVerification(IV&V)contractorsintheireffortstoprovideindependent
assessmentofVendorscompliancewiththeContractresultingfromthisRFP.Suchcooperationincludes
agreementtocooperatewithandmakeinternalrecords,personnel,Projectcontrolsystemsandother
supportinformationavailableonareasonablebasisasrequestedbytheAuthorityortheQAandIV&V
contractors.
5.2 (M)ProjectManagementRequirements
VendormustprovidearesponsetotherequirementsincludedinthedocumentAppendixB:Project
ManagementRequirementsattachedwiththisRFP.Vendorsmustrespondwithintheappendix.
5.3 (M)ExchangeBusiness/FunctionalRequirements
VendormustprovidearesponsetotherequirementsincludedinthedocumentsAppendixC:Business
FunctionalRequirementsandAppendixP:EligibilityServiceRequirementsattachedwiththisRFP.
Vendorsmustrespondwithintherespectiveappendix.
5.4 (M)TechnologyRequirements
VendormustprovidearesponsetotherequirementsincludedinthedocumentAppendixD:Technology
RequirementsattachedwiththisRFP.Responsesareexpectedtobedocumentedwithintheappendix.
5.5 (M)Warranty
TheWarrantyperiodwillbeginonthedayaftertheExchangePortalhasbeenAccepted.Acceptance
willoccuraftertheimplementationofrequiredfunctionalityasdefinedinAppendixC:
Business/FunctionalRequirementsandAppendixD:TechnologyRequirementsandwhentheentire
HealthBenefitExchangeisoperatingwithoutdeficiency,asdefinedinAppendixB,Section5.2.4.9and
5.2.4.10.

TheWarrantyPeriodwillbeforaperiodofsix(6)monthsduringwhichtheVendorwillberesponsible
fortheWarrantyServicesasdescribedinAppendixFProposedContractatnoadditionalcosttoHCA.
(M)TheVendormustcertifythattheyhavereadandunderstandtheWarrantyprovisionsasdefinedin
AppendixFProposedContract.
SECTION6

6 FinancialProposal
RespondtothefollowingrequirementspertheinstructionsinSection3.9:ProposalPresentationand
FormatRequirements.
6.1 (M)GeneralProvisions
TheContractresultingfromthisacquisitionwillbeafixedprice,deliverablebasedContract.Inthe
FinancialProposal,Vendorswillprovideinformationregardingthedeliverables,staffhoursper
deliverable,thedeliverydates,andthecostofdeliverables.
TheAuthoritywillpayfordeliverablesonthefollowingbasisasshownintheDeliverablesCosttabof
AppendixKFinancialProposal:
22.5percentoftheagreed,fixedpricewillbepaiduponVendordelivery(VendorDelivery)
45percentoftheagreed,fixedpricewillbepaiduponAuthorityacceptance(Authority
Acceptance);
22.5percentoftheagreed,fixedpricewillbepaiduponFederalcertificationandacceptance
(CMSCheckin);and
10percentoftheagreed,fixedpricewillbepaidatTurnoverofthesystemattheendofthe
Warrantyperiod(Holdback).
OperationsandMaintenancechargeswillbepaiduponreceiptofacorrectinvoicefordefined
deliverableswithin30daysofreceiptofaninvoiceforservicesprovidedinthepreviousmonthas
specifiedintheO&MtabofAppendixKFinancialProposal.
6.2 (M)FinancialProposalRequirements
TheAuthorityrequiresthefollowingoftheFinancialProposal:
AllVendorcosts(e.g.,technicalstaff,managementstaff,travel,overhead)aretobeincludedin
thepriceofthedeliverables.
ThedeliverablesmustbethesameasthoseinthelistedinSection5.2.6.2,Deliverableby
PaymentMilestoneandintheWorkPlan(s)forProjectManagement,Business/Functional,and
Technicalactivities.
Theproposalmustbefreefrommathematicalerror.(Minorroundingerrorsarenotconsidered
mathematicalerrors.)
Theproposalmustincludeallcostsasdescribedinthissection.
TheFinancialProposalmustbeaccompaniedbyacopyoftheWorkPlanthatincludesallthe
deliverablesspecifiedintheFinancialProposal.HCAwillnotpayforproductsnotdescribedin
thisplan.

6.3 (MS)FinancialRequirementsHealthBenefitsExchange
Completion
Allpaymentsunderthecontract,exceptoperationsandmaintenanceservices,willbeforthedeliveryof
tangible,completedproducts.TheminimumworkproductsaretheExchangeProjectdeliverables
identifiedinAppendixB:ProjectManagementRequirements;AppendixC:Business/Functional
Requirements;andAppendixD:TechnologyRequirements.
TheVendorisresponsibleforincludingallcostcomponentsintheproposedcostproposal.
ManagementcostsaswellasallothercoststotheContractor(including,butnotlimitedto:facilities,
computers,software,equipment,telecommunications,travelandlivingexpenses/perdiem,salesoruse
taxesandlicensingfees)shallbeincludedasoverheadtothetechnicalcostofcompletingExchange
Projectdeliverables,andwillnotbeseparatelyreimbursed.
TorespondtotheFinancialRequirementssetforthinthissection,VendormustutilizetheExcel
spreadsheetscontainedinAppendixK:FinancialResponse.
6.3.1 VendorPricing
VendorsmustsubmitAppendixK,FinancialResponse,whichisamultitabspreadsheetfortheVendor
toentertheircostproposalintheindividualworksheetsasfollows:
DeliverablesCost:Thisworksheetsummarizesthecostsfromalltheotherdetailworksheets.
TherearefouryellowhighlightedcellsonthisworksheetfortheVendortocomplete:
o Vendor:EnterVendorName
o BasicHealthOption:Determiningeligibilityandcoordinatingenrollmentfor
WashingtoncitizensintheFederalBasicHealthOptioniswithinthescopeofthisRFP.
TheFederalBasicHealthOptionisaprogramthatprovidesanadditionallowcosthealth
carecoveragealternativeforindividualswhoarebetween133%and200%ofthe
FederalPovertyLimit.TheAuthorityrequestsvendorstoprovidetheestimatedcostfor
theBasicHealthprogram.
o EnrollmentTransactionsforQualifiedHealthPlans:Generatingenrollmenttransactions
forQualifiedHealthPlans(nonMedicaid/CHIP/BasicHealth)iswithinthescopeofthe
RFP.TheAuthorityrequestsvendorstoprovidetheestimatedcostforgenerating
enrollmenttransactionsfortheQualifiedHealthPlans.
o OptionalExchangeEligibilityServices:AsdefinedinAppendixP,theAuthoritymay
requesttheVendortodeveloptherequiredExchangeEligibilityServices
Allothercellsonthisworksheetarelockedandarecompletedbyformulasthatreferencethe
otherworksheets.
O&MCosts:EnteralistofproposedmonthlydeliverablesandcostsfortheO&Mservicestobe
providedbytheVendor
CRHourlyCosts:EntertheRoleNameandLoadedHourlyCostfortheVendorstaffrolestobe
providedfortheExchangeProject.Ataminimum,thismustcontainallthekeystaffpositions
identifiedinAppendixA,Section4.4.3.4
EnhancementHourlyCosts:EntertheRoleNameandLoadedHourlyCostfortheVendorstaff
rolestobeprovidedduringtheO&MperiodforExchangesystemenhancements.
InfraProject:EnterthedescriptionofHardwareandSoftwarecomponentstobeprovidedfor
thedevelopmentoftheExchange,theirunitcostsandnumberofunitstobeprovidedforthe
fivenamedenvironments(Development,System&IntegrationTest,Training,UserAcceptance
Test,andProduction)

InfraO&M:EnterthedescriptionofHardwareandSoftwarecomponentstobeprovidedfor
theOperationsandMaintenanceoftheExchange,theirunitcostsandnumberofunitstobe
providedforthefournamedenvironments(Development,System&IntegrationTest,User
AcceptanceTest,andProduction)
Worksheets1PlanMgmtto7Administration:Theseworksheetsareprovidedforthe
VendortoenterdetailsconcerningthemainfunctionalitybreakdownoftheExchangeandshow
estimatedefforthoursandcost.Twostandardentriesareprovided:
o ExchangeWebPortal/UserExperience:Enterestimatedefforthoursdodesign,
develop,testanddocumenttheuserinterfaceforthefunctionality.
o Functionality:Enterefforthoursandcostsforthefunctionalityorbreakitdowninto
subfunctionsandenterefforthoursandcostsperlineitem.
Ataminimum,thevendormustenteronedetaillinecontainingthetotalcostforthatfunctional
area.TheAuthorityprefersthattheVendorssubdividethemainfunctionalityintodiscrete
piecesandprovidebothefforthoursandcost.
6.3.2 SoftwareandEquipmentCosts
TheVendormustlistallSoftwareandEquipmentnecessary,andallassociatedcoststodevelop,test,
andoperatetheProject.Equipmentwillincludeallservers,switches,racks,telecommunications,orany
otherequipmentthatwillbeusedintheExchangesystem.Softwaremustincludesoftwareusedto
supportongoingoperationsandmaintenanceinitialcostsandoneyearmaintenance/licensingcosts.
VendorsmustsubmitAppendixK:FinancialResponse(SoftwareandEquipment).
6.3.3 OperationsandMaintenance
TheVendormustproposeone(1)yearofoperationsandmaintenanceoftheExchange.Thecostforthe
one(1)yearofOperationsandMaintenancewillbeincludedinthecostevaluationoftheVendors
proposal.
AttheoptionoftheAuthority,thecontractresultingfromthisRFPfortheOperationsandMaintenance
Servicesmaybeextended,onanannualbasis,foruptosix(6),one(1)yearadditionalterms.Thecost
foreachadditionaltermshallbeatthecostspecifiedintheVendorsproposal,adjustedannuallybythe
CONSUMERPRICEINDEX,SEATTLEAREA.
6.3.4 TotalCostofProject
ThetotalcostoftheProjectisasummationoftheabovecalculations.VendorsmustsubmitAppendixK:
FinancialResponse.
VendorsmustsupplysupportingdocumentationforthedeliverablesandtotalProjectcost.
6.4 (MS)OptionalTasks
ThisRFPincludesoptionaltasksforwhichtheAuthoritymaychoosetocontract.
Proposalsmustinclude:
HourlyratesforPreImplementationChangeRequests(atmultipleratesdependingonthetype
ofdeveloper);
HourlyratesforPostImplementationEnhancementRequests;and
HourlyratesandprojectedhoursforpostWarrantyPeriodEnhancementactivitytomaintain
theExchangeatthelevelsindicatedinSection0WarrantyPeriodServiceLevels.
HourlyratesshouldincludeallVendoractivity,includingmanagement,foreachactivity.


SECTION7
7 EVALUATIONPROCESS
7.1 Overview
Thesolicitationandselectionprocesswillbestaged:
VendorswillsubmitProposalsinresponsetotherequirementslistedinthisRequestfor
Proposal.
MandatoryRequirements(M)andMandatoryScoredRequirements(MS)willbescreenedfor
completeness.ProposalsthatfailtomeetanyMandatoryRequirementswillbeeliminatedfrom
furtherconsideration.
MandatoryScoredRequirements(MS)andDesirableScoredRequirements(DS)willbescored.
TheVendorsreceivingthehighestscoreswillbeinvitedtopresentanddemonstratetheir
solutionsfortheExchangePROJECTanddemonstratetheircapabilitiestomeettheAuthoritys
Exchangeneeds.
ThefinalistcandidatesmayberequestedtosubmitaBestandFinalOfferperRFPsubsection
3.20
AnApparentlySuccessfulVendor(ASV)willbeselectedfromamongthefinalistsmaking
presentationsanddemonstrations.
TheAuthoritywillnegotiateacontractwiththeASV.
7.2 AdministrativeScreening
ProposalswillbereviewedinitiallybytheRFPCoordinatortodetermineonapass/failbasiscompliance
withadministrativerequirementsasspecifiedinSection3:AdministrativeRequirements.Evaluation
teamswillonlyevaluateProposalsmeetingalladministrativerequirements.
7.3 MandatoryRequirements
Proposalsmeetingalloftheadministrativerequirementswillbereviewedonapass/failbasisto
determineiftheProposalmeetstheMandatoryrequirements(Sections4:VendorRequirements;
Section5:ExchangeRequirements;andSection6:FinancialProposalandAppendixA:Vendor
OrganizationalCapabilities,AppendixB:ProjectManagementRequirements,AppendixC:
Business/FunctionalRequirements,AppendixD:TechnologyRequirements,AppendixP:Eligibility
ServiceRequirements,AppendixK:FinancialResponse).OnlyProposalsmeetingallMandatory
requirementswillbefurtherevaluated.
TheAuthorityreservestherighttodetermineatitssolediscretionwhetherVendorsresponseto
Mandatoryrequirementsissufficienttopass.If,however,allrespondingVendorsfailtomeetanysingle
Mandatoryitem,theAuthorityreservesthefollowingoptions:(1)canceltheprocurement,or(2)revise
ordeletetheMandatoryitem.
7.4 QualitativeReviewandScoring
OnlyProposalsthatpasstheadministrativescreeningandMandatoryrequirementsreviewwillbe
evaluatedandscoredbasedonresponsestothescoredrequirementsintheRFP.Proposalsreceivinga
0onanyMandatoryScored(MS)element(s)willbedisqualified.

7.4.1 VendorClientReferences

TheRFPCoordinatorshouldreceiveallReferenceformsonorbeforethetimeanddateofVendor
ProposalsDue(referenceRFPSchedule;Section2).Ifmorethanthreecustomerreferencesare
received,onlythreeselectedbytheRFPCoordinatorshallbeconsideredduringproposalevaluation.
TheVendorClientReferences(Section4.8)willbeworth50pointsor5percentofthetotalpoints
awardedinthescoringoftheproposals.
TheRFPCoordinatorwillassignscoresforeachsetofVendorreferencesbasedonthefollowing:
TheVendorreceivingthehighestnumberofpointswillreceiveascoreof50.
OtherVendorswillreceiveascorebasedonthefollowingformula:
VendorScore=(VendorPointsHighestVendorPoints)X50
7.4.2 Administrative,ProjectManagement,Business/FunctionalandTechnology
ScoredRequirements(MS,DS)Evaluation
ScoredRequirementswillbeworthatotalof750pointsor75percentofthetotalpointsawardedinthe
scoringoftheproposals.VendorswillbeevaluatedoneachMandatoryandDesirableScored
RequirementinprevioussectionsofthisdocumentandinAppendixB:ProjectManagement
Requirements;AppendixC:Business/FunctionalRequirementsand;AppendixD:Technology
Requirements.EvaluatorswillassignpointstoeachMandatoryandDesirableScoredrequirementbased
ontheeffectivenessandcompletenessoftheProposaltoeachrequirement.
Totalpointswillbesummedforeachofthefourrequirementssections.TheEvaluationteamswillassign
scoresforeachofthesesections(VendorRequirements;ProjectManagementRequirements;
Business/FunctionalRequirements;TechnologyRequirements)basedonthefollowing:
TheVendorreceivingthehighestnumberofpointsforVendorRequirementswillreceiveascore
of150.
TheVendorreceivingthehighestnumberofpointsforProjectManagementRequirementswill
receiveascoreof200.
TheVendorreceivingthehighestnumberofpointsforBusiness/FunctionalRequirementswill
receiveascoreof200.
TheVendorreceivingthehighestnumberofpointsforTechnologyRequirementswillreceivea
scoreof200.
OtherVendorsineachofthefourrequirementssectionswillreceiveascorebasedonthefollowing
formula:
VendorScore=(VendorPointsHighestVendorPoints)Xscoreforthesection(e.g.,150for
VendorRequirements).
AscoreofzerobyallevaluatorsonanyMandatoryScoredRequirementwillresultintheProposalbeing
disqualified.
7.4.3 FinancialProposalEvaluation
TheFinancialProposalwillbeworth200pointsor20percentofthetotalpointsawardedinthescoring
oftheproposals.TheproposalwillbeevaluatedbasedonVendorsrealisticpricingapproach.
VendorPrice:
TheFinancialEvaluationTeamwillscoretheVendorspriceforfixedpricedeliverablesand
changerequestpricing,where:
TheVendorsubmittingthelowestTotalCostofProjectwillreceiveascoreof160.

TheVendorsubmittingthelowestChangeRequestEvaluationPricingwillreceiveascoreof
40.Forcalculationpurposes,thiswillbebasedonthefollowing:
o 500hoursofprojectmanagementservices
o 500technicalsystemarchitectservices
o 1000hoursofbusinessanalysisservices
o 3000hoursofdeveloperservices
ItshouldbenotedthatthesefourpositionsarepredefinedintheCRHourlyCosts
worksheet.
Onbothitems,otherVendorswillreceiveascorebasedonthefollowingformula:
VendorScore=(LowestVendorPriceVendorPrice)Xmaximumscorefortheitem
7.5 VendorTotalScore
TheVendorTotalScorewillbecalculatedasfollows:
EvaluationCategory Score
VendorRequirements(Section4) 150
VendorReferences 50
ProjectManagementRequirements 200
Business/FunctionalRequirements 200
TechnologyRequirements 200
FinancialProposal 200
TotalScore 1,000

7.6 OralPresentations/Demonstrations,SectionofApparently
SuccessfulVendor
TheAuthority,afterevaluatingthewrittenproposals,willscheduleoralpresentations/demonstrations
forataminimumthetopthree(3)*scoringfinalists.TheRFPCoordinatorwillnotifyfinalistsofthedate,
timeandlocationoftheoralpresentationanddemonstration.ThedatesinSection2:Scheduleare
subjecttochangeatthediscretionoftheAuthority.
TheVendorsmakingoralpresentationsanddemonstrationswillbegroupedintoanunrankedpoolof
finalists.Aftertheoralpresentations/demonstrations,vendorswillberankedbasedontheoverall
qualityoftheiroralpresentations/demonstrations.UnlesstheAuthoritydeterminesaBestandFinal
Offerprocessisnecessary,theAuthoritywillnametheVendorrankedfirstastheApparentlySuccessful
Vendor.
*TheAuthorityreservestherighttoincreasethenumberoffinalistsifthescoresaresoclosetogethersoasto
createaclusterofmorethanthreeatthetopofthescoringrange.

7.7 ContractingProcess
TheAuthoritywillenterintocontractnegotiationswiththeASV.AnASVwillbeexpectedtoexecutethe
Contractwithinten(10)BusinessDaysofitsreceiptofafinalContractfromHCA.IfaselectedVendor
failstosigntheContractwithintheallottedten(10)daytimeframe,HCAmaydeclarenegotiationsatan
impasse,electtocanceltheaward,andawardtheContracttothenextrankedVendor,orcancelor
reissuethissolicitation(seeSubsection3.17,RighttoCancel).VendorssubmissionofaProposaltothis
solicitationconstitutesacceptanceofthesecontractrequirements.Thisprocesswillcontinueuntila
Contractissigned,noqualifiedVendorsremain,ortheAuthorityelectstocancelorreissuethe
solicitation.
TheagreeduponcontractissubjecttoStateandfederalapproval.

Request For Proposal Number K521: Health Benefits (Insurance) Exchange Systems Integrator Services

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