INDIANA DEPARTMENT OF ADMINISTRATION Risk-Based Managed Care Services for Medicaid Beneficiaries (Hoosier Healthwise / HIP) REQUEST FOR PROPOSAL on behalf of the Family and Social Services Administration 1

INDIANA DEPARTMENT OF ADMINISTRATION GENERAL INFORMATION Attendee Sign-In Sheet Sign-In Sheet and PowerPoint will be posted on State’s Solicitation Website 2

INDIANA DEPARTMENT OF ADMINISTRATION RFP QUESTIONS AND ANSWERS Questions answered verbally today are not official nor binding and should be submitted in writing if it will affect your proposal response (Q/A Template). All questions must be submitted using the Question and Answer Template provided by 3:00 PM Eastern Time on October 22, There will be a separate Question and Answer period after capitation rate information is released. 3

INDIANA DEPARTMENT OF ADMINISTRATION ACCESSING RFP DOCUMENTS 4

INDIANA DEPARTMENT OF ADMINISTRATION ACCESSING RFP Documents 5

INDIANA DEPARTMENT OF ADMINISTRATION 6

RFP OVERVIEW Proposals Required for Both Programs: It is the intention of the State to award the contracts for Hoosier Healthwise and HIP together to the same contractors. Therefore, all Respondents must submit proposals for both the Hoosier Healthwise and HIP programs. Distinct Evaluations: Portions of the evaluations for Hoosier Healthwise and HIP will be performed distinctly. This means that in some parts of your proposal you must submit responses that independently address Hoosier Healthwise and HIP. Multi-Stage Evaluation: The State will evaluate proposals in separate stages. The State will first evaluate proposals on a business and technical basis. After these initial evaluations, and short- listing of Respondents (optional), the State will release capitation rate information to the remaining Respondents, who will then submit cost proposals. IDOA will perform a final stage of evaluations on the Indiana preferences. 7

INDIANA DEPARTMENT OF ADMINISTRATION KEY RFP DATES 8

INDIANA DEPARTMENT OF ADMINISTRATION RFP OUTLINE 9

INDIANA DEPARTMENT OF ADMINISTRATION PURPOSE AND SCOPE OF RFP The purpose of RFP is to contract, on a Statewide basis, with managed care organizations (MCOs) to provide risk-based managed care services to beneficiaries enrolled in the State of Indiana’s Hoosier Healthwise and Healthy Indiana Plan (HIP) programs. Scope of Work Table of Contents – HIP 1.Background 2.Managed Care Entity Respondent Req’s 3.HIP Plan Design and Member Eligibility 4.Billing and Collections 5.Personal Wellness & Responsibility (POWER) Accounts 6.Covered Benefits and Services 7.Member Services 8.Provider Network Requirements 9.Quality Management and Utilization Management 10.Program Integrity 11.Information Systems 12.Performance Reporting and Incentives 13.Failure to Perform/Non-Compliance Remedies 14.Termination Provisions Scope of Work Table of Contents – HHW 1.Background 2.Managed Care Entity Respondent Req’s 3.Covered Benefits and Services 4.Member Services 5.Provider Network Requirements 6.Quality Management and Utilization Management 7.Program Integrity 8.Information Systems 9.Performance Reporting and Incentives 10.Failure to Perform/Non-Compliance Remedies 11.Termination Provisions 10

INDIANA DEPARTMENT OF ADMINISTRATION BUSINESS PROPOSAL Company Financial Information (Section 2.3.3) Confidential information must be kept separate from the proposal. 11

INDIANA DEPARTMENT OF ADMINISTRATION TECHNICAL PROPOSAL The Technical Proposal response will be divided into three components: 1.Common Component (requirements for both HHW and HIP) 2.Hoosier Healthwise Component 3.HIP Component A complete technical proposal (common component plus both program-specific components), including attachments and exhibits, should not exceed 2,000 pages in 10 point font with standard margins 12

INDIANA DEPARTMENT OF ADMINISTRATION COST PROPOSAL The State will evaluate this proposal in separate stages. The State will first evaluate proposals on a business and technical basis. After these initial evaluations, and short-listing of Respondents (optional), the State will release capitation rate information to the remaining Respondents. Therefore, the Cost Proposal will not be available until after the Rates and Data Book is released. A separate presentation and Q&A round will be held in the spring focused on the capitation rates and the Cost Proposal. 13

INDIANA DEPARTMENT OF ADMINISTRATION MINORITY AND WOMEN’S BUSINESS ENTERPRISE If Respondent is asked by the State to submit a cost proposal after the initial evaluations, they shall submit Attachment A with their cost proposals. Attachment A, MWBE Form - Include sub-contractor letters of commitment Goals for this RFP: - 8% Minority Business Enterprise - 8% Women’s Business Enterprise 14

INDIANA DEPARTMENT OF ADMINISTRATION MINORITY AND WOMEN’S BUSINESS ENTERPRISE 15

INDIANA DEPARTMENT OF ADMINISTRATION INDIANA VETERANS’ BUSINESS ENTERPRISES SUBCONTRACTOR COMMITMENT (ATTACHMENT A1) If Respondent is asked by the State to submit a cost proposal after the initial evaluations, they shall submit Attachment A1 with their cost proposals. Attachment A1, IVBE Form -Include sub-contractor letters of commitment -Goal for this RFP: 3% 16

INDIANA DEPARTMENT OF ADMINISTRATION INDIANA VETERANS’ BUSINESS ENTERPRISES SUBCONTRACTOR COMMITMENT (ATTACHMENT A1) 17

INDIANA DEPARTMENT OF ADMINISTRATION INDIANA ECONOMIC IMPACT If Respondent is asked by the State to submit a cost proposal after the initial evaluations, they shall submit their Indiana Economic Impact form with their cost proposals. Note on FTEs: The State defines FTE as a measurement of an employee's productivity on a specific project or contract. A FTE of 1 would mean that there is one (1) worker fully engaged on a project; forty (40) hours a week, fifty-two (52) weeks a year. If there are two (2) employees each spending 1/2 of their working time, 20 hours per week, on a project that would also equal 1. 18

INDIANA DEPARTMENT OF ADMINISTRATION RFP SCORING AND EVALUATION Notes: The State reserves the right to exclude proposals from the “short list” on the basis of financial stability. The financial stability of Respondents to this RFP is expected to be evaluated based in part on Risk Based Capital Ratio (“RBC Ratio”) of the Respondent and its ultimate controlling parent. 19

INDIANA DEPARTMENT OF ADMINISTRATION QUESTIONS AND ANSWERS 20

Additional Information IDOA PROCUREMENT LINKS AND NUMBERS BUYIN (8946) For Vendor Registration Questions For Inquiries Regarding Substantial Indiana Economic Impact Secretary of State of Indiana: Can be reached at (317) for registration assistance. See Vendor Handbook: Online version available at Minority and Women Owned Business Enterprises: for table of IDOA certified MBEs and WBEs. For more MWBE information Veteran’s Business Enterprise Program: for a search of certified IVBE’s. For more IVBE’s information RFP posting and updates: Go to (select “State of Indiana Opportunities” link) Drag through table until you find desired RFP/RFI number on left-hand side and click the link. 21