Enrollment Broker Systems and Services

Background
The Michigan Department of Health and Human Services (MDHHS) is responsible for providing information, assistance, and operational support for beneficiaries of health care programs. The Enrollment Broker Vendor will support these tasks under the oversight of the Customer Service Division (CSD). The contract aims to secure a Beneficiary Services Contractor to assist over 2.5 million beneficiaries in accessing services through Medicaid and CHIP programs, including Medicaid, Healthy Michigan Plan, MIChild, and others.

The contractor will streamline enrollment processes, manage data, facilitate health plan assignments, and provide a self-service portal for beneficiaries.

Work Details
The contractor will provide comprehensive enrollment broker services that include:
1. Managing member enrollment into Medicaid health plans.
2. Establishing a robust system for managing member and health plan data.
3. Facilitating efficient health plan assignments.
4. Delivering a self-service portal for beneficiaries to check eligibility and enrollment status, request miHealth cards, etc.
5. Providing call center services for beneficiary inquiries and assistance with enrollment processes.
6. Mailing services for enrollment packets, confirmation letters, and other communications to beneficiaries.
7. Ensuring compliance with federal and state laws regarding independence from managed care entities to avoid conflicts of interest.

Period of Performance
The contract will have a term of five base years with five one-year options.

Place of Performance
Services will be performed within the State of Michigan as specified by MDHHS.

Bidder Requirements
Bidders must comply with federal law prohibiting conflicts of interest with managed care entities or health care providers in Michigan. They must maintain independence from any health care organization or provider during the contract term. Additionally, bidders must provide details on their ability to meet service level agreements and data security requirements as outlined in the solicitation.