Health Insurance Exchange Platform

The vendor is required to provide health insurance exchange (HIX) platform, that supports a single enrollment application used to determine applicants’ eligibility for health and dental plans, financial help, and low and no-cost coverage through husky health or the covered state program.
- New platform and implementation services
•    The new platform must be a secure, simple, user-centric platform which must adhere to all existing standards and requirements, while being scalable and capable of accommodating future changes. 
•    The new platform must be designed in a user-centric manner, making the application process and language as simple and intuitive as possible. 
•    The new platform must be architected using best practices and technologies which allow for rapid deployment of new and changed features and requirements, as well as modular integration with other tools, as warranted. 
•    The new platform must leverage data from trusted sources, whenever possible, and incorporate artificial intelligence tools to improve the efficiency of the workflow and overall user experience.
o    The new platform must comply with all data integration requirements, as mandated by the centers for medicare and Medicaid services (“CMS”) and the internal revenue service (“IRS”), for connectivity to the federal data services hub (“FDSH”) and any other data sources identified by agency or department.
o    The new platform must integrate with existing platforms for group health coverage, including the exchange’s small business health options program (“shop”) platform, and the exchange’s business plus platform, which among other things, allows employers to offer and administer individual coverage health reimbursement arrangements (“ICHRAS”).
•    Marketplace production environment
o    By the platform operation readiness deadline, which is set as June 2027, the selected respondent must configure, and release a public-facing marketplace production environment, that meets all requirements in accordance with contracted terms and conditions. 
o    The marketplace production environment must contain the data from the data conversion and migration plan. 
o    Respondent must guarantee the continuous and current availability and functionality of the new platform and allow users access to the new platform in advance of the 2027 open enrollment period for plan year 2028, meeting the standards set by the platform operation readiness guidelines. 
o    Users with coverage spanning plan year 2027 must also be able to use the new platform to report household demographic and income changes, etc.
o    Include and make available all QHP and SADP data from the staging environment, in the new platform to allow applicants to compare options anonymously and shop throughout a plan year.
•    New platform deliverables
o    Functional design document: this document must comprehensively detail the functional design of the selected respondent’s proposed new platform, including details regarding the proposed new platform’s security functionality. 
o    Interface documentation: the selected respondent must deliver documents that include all real time and batch interfaces comprehensively. 
o    Provide any recommendations for future enhancements. 
o    Technical design documentation: the selected respondent must deliver comprehensive and complete technical design documentation for the proposed new platform, detailing overall system architecture, database design, technologies and tools to be used, integration with other internal and external systems, as well as security and performance considerations. 
o    The processing and functionality of the following topics:
1.    Interface relationships, dependencies, and formats;
2.    Interface design elements, assumptions, and constraints;
3.    Transactional, data validation, and business rules;
4.    Event and error handling;
5.    General processing steps;
6.    Data mapping and transformation; and
7.    Privacy, security, and performance
o    Data dictionary: the selected respondent must deliver a data dictionary, database schema diagram, and an entity-relationship diagram with specifics related to elements that will be necessary for related data conversion. 
o    Data conversion must also be completed by the selected respondent. 
o    Implementation plan: the selected respondent must deliver an implementation plan to organize and roll out the project implementation activities to allow for the transition to maintenance and operations activities. 
o    This plan must specifically support agency and department through the aforementioned processes, while also outlining the specific roles related to the selected respondent and agency and department respectively.
- Maintenance and operations services
•    System maintenance: activities outlined in the agency maintenance and operations manual which remove and repair processing or performance errors, prevent system errors or vulnerabilities, and ensure compatibility with new technology standards or new software and operating system releases.
•    System availability management: activities related to the monitoring, reporting, and optimization of the supported systems, including, but not limited to, resource usage, performance degradation or issues, task automation recommendations, and delivery of root cause analysis (RCA), as applicable. 
•    Batch management: activities related to scheduling, executing and monitoring batch processes across supported environments, including remediation of batch failures and issues.
•    Incident management and resolution: activities outlined in the agency incident management manual related to management, review, triage, analysis, and disposition of incidents reported in production, training and testing environments.
o    Data corrections: activities related to the development and execution of ad hoc or recurring scripts to address data issues resulting in loss of system functionality or block use of benefits.
o    Platform code fix: activities related to the design, development, test and deployment of critical priority incidents, when required by agency. 
o    Coordination and communication: activities related to communication with resources from agency and other vendors, as needed, to discuss, analyze, resolve and prevent future instances of production incidents.
•    Configuration and deployment management: activities, as outlined in the agency maintenance and operations manual, related to the configuration and deployment of software builds and releases, including, but not limited to, server and environment management, user profile management, version control, maintenance of source code repositories, etc. 
•    Disaster recovery and support: activities related to preparing, maintaining and testing disaster recovery plans for the new platform. 
•    Security: activities related to the scanning, monitoring, reporting and resolution of incidents involving access, user credentials, network security, etc. 
•    Consistent and ongoing compliance with responsibilities, as specified by agency. 
•    Maintenance and updates to the new platform, as required, including, but not limited, to any requested modifications or updates required by agency. 
•    Assured compliance with any and all change management processes, as specified by agency. 
•    All changes impacting the new platform must adhere to the hybrid agile methodology, as specified in the agency maintenance and operations manual, which includes a comprehensive release testing plan, application and security scans, and performance and load testing (to be performed by the selected respondent) prior to each major release and on an ad hoc basis, as requested by agency.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: October 06, 2025