This Solicitation opportunity from Massachusetts was posted on January 17, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.
DOCX, High priority: read this firstcontract-document
HighAI Summary for Data Management and Confidentiality Agreement (DMCA): This document is a Data Management and Confidentiality Agreement (DMCA) associated with a Master Services Agreement (MSA) for the Commonwealth Health Insurance Connector Authority. It establishes the legal framework for the handling, privacy, and security of Personally Identifiable Information (PII) and Commonwealth Security Information, ensuring compliance with HIPAA, MGL ch. 93H, and other federal and state data protection laws.
DOCX
DOCX, High priority: read this firstrfp
HighAI Summary for Enrollment and Premium Billing Business Operations Services RFR: Issued January 17, 2025, by the Commonwealth Health Insurance Connector Authority, this Request for Responses (RFR) seeks qualified vendors to provide Enrollment and Premium Billing (EPB) business operations services. The scope includes EDI, federal reporting, notice generation, member portals, and financial management services compliant with ACA and MARS-E regulations.
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for Exhibit K - Remote Work Requirements: This document outlines the requirements and mandatory agreements for contractor personnel working remotely for the Health Connector. It includes security and privacy standards, a template for a Contractor Internal Telecommuting Policy (Exhibit 1), and a Mandatory Telecommuting Agreement (Exhibit 2) that employees must sign to ensure the protection of personal information and data security while working from home.
DOCX
DOCX, High priority: read this firstcontract-document
HighAI Summary for Health Connector Modified Terms and Conditions: This document outlines the Modified Terms and Conditions for the Commonwealth Health Insurance Connector Authority. It establishes the legal and operational framework for contracts, including payment mechanisms, termination clauses, intellectual property rights, liability limits, and procedures for scope of work change orders.
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for Health Connector Report List: Attachment 5 provides a detailed list of 20 required reports (RPT-1 through RPT-20) for the Health Connector. It specifies the report names, business purposes, and required frequencies, covering areas such as financial reconciliation, federal reporting (CMS/IRS), enrollment accuracy, and member portal usage.
DOCX
DOCX, High priority: read this firstcontract-document
HighAI Summary for MSA - Health Connector Enrollment and Premium Billing Services: A Master Services Agreement (MSA) between the Commonwealth Health Insurance Connector Authority and a vendor for Health Connector Enrollment and Premium Billing services. The document outlines contractor responsibilities, technology infrastructure, payment terms, and administrative requirements following a Request for Responses (RFR) issued on January 17, 2025.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Attachment 10 - Member Correspondence: This document is a technical specification attachment (Attachment 10) detailing member correspondence requirements. It provides a comprehensive list of notices, including their business purpose, trigger events, target populations, and estimated monthly and annual volumes for various enrollment and billing communications.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Attachment 14 - Requirements Traceability Matrix: A Requirements Traceability Matrix (RTM) for a Health Connector procurement. The document lists detailed functional requirements related to enrollment, EDI X12 834 file exchange, and carrier reconciliation, requiring bidders to indicate their system's capability to meet each requirement (standard, configuration, or modification).
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for RFR Attachment 2 - Technical Standards: This document outlines the mandatory technical, security, and accessibility standards for contractors providing IT services to the Health Connector. It specifies compliance with Federal CMS standards, HIPAA, PCI 4.0, Massachusetts state laws (including EOTSS and EOHHS policies), NIST guidelines, and Section 508 accessibility requirements. It also addresses data ownership and prohibits the unauthorized use of generative AI.
DOCX
DOCX, High priority: read this firstsupporting-documents
HighAI Summary for RFR Attachment 7 - Mandatory Forms and Certifications: This document contains a set of mandatory certification forms (Schedules 1-6) required for a bid response. It includes certifications for bidder qualifications, key personnel availability, subcontractor responsibility, financial condition, W-9 tax identification, and debarment/suspension status.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Attachment 8 - Cost Response Instructions and Workbook: This document provides detailed instructions and a structured workbook for bidders to submit their cost responses for a Health Connector procurement. It includes specific pricing tables for Year 1 Transition and Implementation (July 1, 2025 - June 30, 2026), covering labor, staff readiness, and technology costs. The document specifies that the cost response must be all-inclusive and prohibits PMPM/PCPM cost responses, while allowing for alternate cost structures.
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for RFR Attachment 9 - Defined Terms: This document is Attachment 9 to a Request for Response (RFR), providing a comprehensive glossary of defined terms. It includes technical EDI transaction definitions (820, 834, 999/ACK), legal and regulatory references (ACA, HIPAA, ADA), and operational terminology related to the Health Connector's insurance exchange and enrollment processes.
DOCX
DOCX, High priority: read this firstsow
HighAI Summary for RFR Exhibit A - Current State of Operations: This document is Exhibit A of a Request for Response (RFR) detailing the current state of enrollment and billing operations for the Massachusetts Health Connector. It outlines the scope of EPB Services, including EDI, Federal Reporting, and Member Portals, and describes the existing vendor ecosystem involving OptumInsight, Softheon, and a Contact Center Vendor.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit B - Reference Materials: This document serves as Exhibit B (Reference Materials) for a Request for Response (RFR). It contains operational data including a list of Health Connector Carriers (Health and Dental), a Massachusetts holiday schedule, notice samples (Eligibility Approval and Appeal forms), and membership data for Qualified Health Plans (QHP) from January 2022 through April 2023.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit C - Key Performance Indicators and Service Level Agreements: This document is Exhibit C of a Request for Response (RFR), detailing the Key Performance Indicators (KPIs) and Service Level Agreements (SLAs) for a health connector system. It defines performance standards for system availability, incident reporting, data accuracy, and disaster recovery, including specific financial penalties and credits for non-compliance.
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit E - Accessibility: This document is Exhibit E of a Request for Response (RFR), detailing the accessibility obligations for bidders providing information technology solutions. It mandates compliance with Commonwealth Enterprise Accessibility Standards, Section 508 of the Federal Rehabilitation Act, and WCAG 2.0 Level AA. Key requirements include the submission of VPATs, mandatory accessibility testing both before and after contract execution, and collaboration with an Accessibility Advisory Committee (AAC) and third-party testing vendors.
DOCX
DOCX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit F - Contract Management Portal: This document outlines the requirements for the Contract Management Portal (CMP) to be used by the Bidder and the Health Connector. It specifies that the CMP must serve as a secure, encrypted repository for all project and contract documentation, including agreements, reports, deliverables, and project plans, while ensuring compliance with HIPAA and other data security regulations.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit G - Calendar of Business Events: Exhibit G provides a detailed calendar of business events for the Health Connector, outlining key activities during Open Enrollment (OE) and Closed Enrollment (CE). It includes frequencies and descriptions for critical processes such as rate submission, eligibility determinations, billing cycles, delinquency management, and refund processing to provide bidders with an understanding of ongoing business operations.
XLSX
XLSX, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit H - Technology Matrix: A technical matrix detailing the current and future state of technology assets for a contact center procurement. It lists specific software and platforms (e.g., AWS, Salesforce, MuleSoft, NICE), their current owners/administrators as of 1/1/2025, and requirements for the future state as of 7/1/2026.
PDF
PDF, High priority: read this firstspecifications
HighAI Summary for RFR Exhibit I - Current Process Flows: This document is an exhibit containing a comprehensive list and detailed descriptions of current business process flows for the Massachusetts Health Connector (CCA), including credit sweeps, delinquency, and notice template maintenance. Updated as of December 2024, it serves as technical specifications for operational workflows.
DOCX
DOCX, High priority: read this firstsow
HighAI Summary for RFR Exhibit J - Health Connector for Business (HCB) Scope: This document defines the operational scope for the Health Connector for Business (HCB) small group market in Massachusetts. It details requirements for Contact Center services (inbound/outbound support, reporting, QA), Enrollment and Billing services (quoting, invoicing, broker commissions), and the specific systems (Salesforce, Redmine, Enroll App) required for connectivity. It also includes historical data regarding call volume and membership to inform staffing needs.
DOCX
DOCX, Low prioritypast-performance
LowAI Summary for Business Reference Form: A template form requiring bidders to provide detailed corporate references, including client contact information, contract scope, project team size, and annual operational costs.
PDF
PDF, Low priorityother
LowAI Summary for CCA Employee Handbook: An employee handbook for the Commonwealth Health Insurance Connector Authority (Health Connector), updated as of September 2024. It outlines organizational structure, mission, workplace policies, benefits, leave, and compensation guidelines for employees.
DOCX
DOCX, Low prioritycontract-document
LowAI Summary for MSA Attachment 1 - Order of Precedence: This document establishes the order of precedence for the documents comprising the Agreement between the parties. It lists five tiers of priority, starting with the Data Management and Confidentiality Agreement and ending with the Contractor's response to the RFR.
PDF
PDF, Low priorityelectronic-payment-form
LowAI Summary for RFR Attachment 12 - Electronic Payment Authorization Form via ACH: An ACH Electronic Payment Authorization Form for the Commonwealth Health Insurance Connector Authority (CCA) of Massachusetts. The document is used by payees to provide banking and financial information to enable direct deposit of payments.
DOCX
DOCX, Low prioritysupporting-documents
LowAI Summary for RFR Attachment 4 - Attachment and Exhibit Crosswalk: This document provides a crosswalk table clarifying the relationship between the Attachments and Exhibits of the Enrollment and Premium Billing Request for Response (RFR) and the Master Services Agreement (MSA). It identifies which documents are identical, which are reserved, and which require bidder input for the final contract.
DOCX
DOCX, Low priorityspecial-notice
LowAI Summary for RFR Exhibit D - Integration Specifications and System Architecture: This document serves as a notice regarding Exhibit D (Integration Specifications and System Architecture). It informs interested bidders that the document is confidential and provides specific instructions and a required statement for requesting access via email.
AI Contract Breakdown
Uniform Contract Format
Contract not broken down yet
CLEATUS splits the solicitation into Uniform Contract Format (UCF) sections: scope, pricing, deliverables, and evaluation criteria.
Timeline
PhaseClosed
Posted
Solicitation
Response Deadline
Deadline has passed
Submission Closed
Find active opportunities like this
Get full access to discover similar active contracts, track opportunities, and build proposals with AI assistance.
Organization & Contact Information
Show more
AgencyMassachusetts → Commonwealth Health Insurance Connector Authority