RFP 2014-24: Plan Year 2016 Qualified Health and Dental Plan Certification/Recertification Project: Rate Review and Application Assessment and Reorganization and Training of the Plan Management and SHOP Sales Divisions

This contract awards a California‑based consulting firm the responsibility for a comprehensive rate‑review, plan certification/recertification, and organizational redesign for Covered California’s 2016 Qualified Health and Dental Plans. The work includes data analysis of premiums, automation of SERFF data uploads, liaison with insurers, and the restructuring and training of the Plan Management and SHOP Sales divisions. The effort is limited to an $700 k ceiling and must be completed by the end of 2015, with a possible one‑year extension. • Conduct full rate‑review and application assessment for 2016 plan year. • Reorganize and train staff in Plan Management and Small‑Business Health Options Program (SHOP) sales divisions. • Deliver automation frameworks, procedural documentation, and post‑certification support within a Time‑and‑Materials framework.