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Iowa Insurance Division Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market pursuant to State Flexibility to Stabilize the Market RFP 19216-04 June 18, 2019

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Request for Proposals for

MARKET SCAN OF THE IOWA INDIVIDUAL HEALTH INSURANCE MARKET PURSUANT

TO STATE FLEXIBILITY TO STABILIZE THE MARKET

RFP 19216-04

Iowa Insurance Division

Two Ruan Center, 601 Locust, 4th Floor, Des Moines, IA 50309-3738

June 18, 2019

Table of Contents

Section 1: Introduction and General Information about this Request for Proposals.

1.1 Purpose.

1.2 Definitions.

Section 2: Administrative Information.

2.1 Issuing Officer.

2.2 Restriction on Communication.

2.3 Downloading the RFP from the Internet.

2.4 Procurement Timetable.

2.5 Bidders’ Conference.

2.6 Questions, Requests for Clarification, and Suggested Changes.

2.7 Letters of Intent to Bid.

2.8 Amendment to the RFP or Bid Proposal or Withdrawal of Bid Proposal.

2.9 Submission of Bid Proposals.

2.10 Bid Proposal Opening.

2.11 Rejection of Bid Proposals.

2.12 Disqualification.

2.13 Nonmaterial and Material Variances.

2.14 Reference Checks.

2.15 Information from Other Sources.

2.16 Verification of Bid Proposal Contents.

2.17 Bid Proposal Clarification Process.

2.18 Disposition of Bid Proposals.

2.19 Public Records and Requests for Confidential Treatment.

2.20 Copyrights.

2.21 Release of Claims.

2.22 Evaluation of Bid Proposals Submitted.

2.23 Award Notice and Acceptance Period.

2.24 Definition of Contract.

2.25 Choice of Law and Forum.

2.26 Restriction on Gifts and Activities.

2.27 Objections.


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Section 3: Service Requirements.

3.1 Introduction.

3.2 Scope of Work.

3.3 Support and Meetings.

3.4 Deliverables.

3.5 Industry Standards.

3.6 Monitoring Plan.

3.7 Performance Review Plan.

3.8 Maximum Allowable Cost.

Section 4: Administrative Information.

4.1 Instructions.

4.2 Technical Proposal.

4.3 Cost Proposal.

Section 5: Evaluation of Bid Proposals.

5.1 Introduction.

5.2 Evaluation Committee.

5.3 Evaluation Criteria.

5.4 Recommendation of the Evaluation Committee.

Section 6: Contract Terms and Conditions.

6.1 Contract Terms and Conditions.

6.2 Contract Length.

Attachment A: Proposal Certification

Attachment B: Certification of Independence and No Conflict of Interest

Attachment C: Authorization to Release Information

Reference.

Appendix A: The State Flexibility to Stabilize the Market Grant Program

Appendix B: Iowa State Flexibility to Stabilize the Market Grant Program Project

Narrative


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Section 1: Introduction and General Information about this Request for Proposals

1.1 Purpose.

The Iowa Insurance Division (the “Division”) is a division of the Iowa Department of Commerce, an

agency of the State of Iowa. The Division is responsible for the regulation and supervision of the

business of insurance, securities and other specific regulated industries in Iowa pursuant to Iowa

Code Chapter 505. The Iowa Insurance Commissioner is the Chief Executive Officer of the Division.

This market scan of the Iowa individual health insurance market (this “Project”) is intended to

evaluate and study Iowa State Flexibility to Stabilize the Market opportunities under Part A of Title

XXVII of the Public Health Service Act. The goals of the Project in addressing guaranteed

availability of coverage and in obtaining a market scan of Iowa’s individual health insurance market

are: to ensure that approved products are appropriately offered for purchase; to ensure that coverage

is comprehensive and affordable; and to determine whether innovative measures are needed either to

strengthen the type of coverage provided or to improve access to coverage.

The Division intends to enter into a contract with a service provider to investigate and explore the

makeup of Iowa’s individual health market by conducting a market analysis of health coverage and

evaluating the gaps and barriers to receiving health care coverage. The Division intends to award a

contract that will begin on August 8, 2019 and end on July 30, 2020. Any contract resulting from this

Request for Proposals shall not be an exclusive contract.

The purpose of this Request for Proposals is to solicit competitive proposals for these services.

1.2 Definitions.

Bidder means a qualified service provider who submits a bid proposal pursuant to this RFP.

Contract means this RFP, addenda thereto, the Bidder’s proposal, and the contractual agreement into

which the Division and the Vendor enter, except that no objection or amendment by the Vendor to

the RFP requirements shall be incorporated by reference into this Contract unless the Division has

accepted the Vendor’s objection or amendment in writing. The Contract constitutes the entire

agreement between the Division and the Vendor. See also Section 2.25.

Division means the Iowa Insurance Division, a division of the Iowa Department of Commerce, an

agency of the State of Iowa.

Evaluation Committee means certain staff members of the Division and other State agencies selected

to serve on the committee that will review, evaluate, and score bid proposals.

Project means the market scan of the Iowa individual health insurance market which is the subject of

this RFP and the resulting Contract.

RFP means this Request for Proposals for Market Scan of the Iowa Individual Health Insurance

Market Pursuant to State Flexibility to Stabilize the Market in Iowa.


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Vendor means the successful Bidder chosen by the Division pursuant to this RFP process.

SECTION 2: ADMINISTRATIVE INFORMATION

2.1 Issuing Officer.

The Issuing Officer, identified below, shall be the Bidders’ sole point of contact regarding the RFP

from the date of issuance of this RFP until the date of the announcement of the successful Bidder.

Ann Outka


Two Ruan Center

601 Locust, 4th Floor

Des Moines IA 50309-3738

Telephone: 515-281-4354

Email: [email protected]

2.2 Restriction on Communication.

From the issue date of this RFP until the date of the announcement of the successful Bidder, Bidders

shall contact only the Issuing Officer or the designated Division contact person, except that Bidders

may contact the State Targeted Small Business Office on issues related to the preference for Targeted

Small Business Entities without prior notification and approval of the Issuing Officer. The Issuing

Officer will respond only to written questions regarding the procurement process. Questions related

to the interpretation of this RFP must be submitted in writing to the Issuing Officer by 4:00 p.m.,

central time, July 9, 2019. Verbal questions related to the interpretation of this RFP will not be

accepted, and no Bidder shall be entitled to rely upon any responses to verbal questions. Bidders may

be disqualified if they contact any state employee other than the Issuing Officer, except as otherwise

authorized by this RFP. In addition to the Issuing Officer, the designated contact person is Chris

Henkel, [email protected], 515-725-4047.

2.3 Downloading the RFP from the Internet.

The RFP and all amendments will be posted on the home page of the Division’s website at

iid.iowa.gov. The Bidder is advised to check the Division’s website periodically for amendments to

this RFP, particularly if the Bidder downloaded the initial RFP from the Internet, as the Bidder may

not automatically receive amendments. If the Bidder received this RFP as a result of a written

request to the Division, the Bidder will automatically receive amendments.

mailto:[email protected]


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2.4 Procurement Timetable.

The following dates are set forth for information and planning purposes; however, the Division

reserves the right to change the dates.

Notice of Intent to Issue RFP

posted on Targeted Small Business Site June 18

Issue RFP June 20

Bidders’ Conference Questions Due 4:00 p.m., June 26, 2019

Bidders’ Conference 2:00 p.m., June 28, 2019

Letters of Intent and Final Questions Due 4:00 p.m., July 9, 2019

Response to Questions Issued July 12, 2019

Closing Date for Receipt of Bid Proposals

and any Amendments to Bid Proposals 4:00 p.m., July 23, 2019

Open Bid Proposals 10:00 a.m., July 24, 2019

Announce Successful Bidder (the Vendor) July 30, 2019

Completion of Contract Negotiations and

Execution of the Contract August 7, 2019

Begin Contract August 8, 2019

2.5 Bidders’ Conference.

A Bidders’ Conference, if necessary, will be held on June 28, at 2:00 p.m., central time, at the offices

of the Division. A prospective Bidder may request to attend the conference by telephone by

contacting the Issuing Officer. The purpose of the Bidders’ Conference is to discuss with prospective

Bidders the work to be performed and allow prospective Bidders an opportunity to ask questions

regarding the RFP. The Division requests that Bidders provide questions in writing by June 26,

2019, but not submitting questions in writing will not preclude Bidders from asking questions at the

Bidders’ Conference or after the Bidders’ Conference until 4:00 p.m., July 9, 2019. Verbal

discussions at the Bidders’ Conference shall not be considered part of the RFP unless confirmed in

writing by the Division and incorporated into this RFP. Questions asked at the conference that

cannot be adequately answered during the Bidders’ Conference may be deferred.


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2.6 Questions, Requests for Clarification, and Suggested Changes.

Bidders are invited to submit written questions and requests for clarifications regarding the RFP.

Bidders also may submit suggestions for changes to the requirements of this RFP. The questions,

requests for clarifications, or suggestions must be in writing and must be received by the Issuing

Officer before 4:00 p.m., central time, July 9, 2019. If the question, request for clarification, or

suggestion pertains to a specific section of the RFP, the page and section number must be referenced.

Written responses to the questions, requests for clarifications, or suggestions will be sent by the

Division on or before July 12, 2019 to Bidders who submitted questions, and will be posted on the

Division’s website. The Division’s written responses will be considered part of the RFP. If the

Division decides to adopt a suggestion, the Division will issue an amendment to the RFP. Certain

materials can be made available electronically at a Bidder’s request; the same information will be

made available to other Bidders.

The Division assumes no responsibility for verbal representations made by its officers or employees

unless such representations are confirmed in writing and incorporated into the RFP.

2.7 Letters of Intent to Bid.

A letter of intent to bid must be received by the Issuing Officer by 4:00 p.m., central time, July 9,

2019. The letter of intent to bid must include the Bidder’s name, mailing address, electronic mail

address, fax number, telephone number, a statement of intent to bid for the Request for Proposals for

Market Scan of the Iowa Individual Health Insurance Market Pursuant to State Flexibility to Stabilize

the Market, and an authorizing signature. Electronic mail and faxed letters of intent to bid will be

accepted.

Submitting a letter of intent to bid is a mandatory prerequisite to submit a bid proposal and to ensure

receipt of written responses to Bidders’ questions and amendments to the RFP. Failure to submit a

letter of intent by the deadline specified will result in the rejection of the Bidder’s bid proposal.

2.8 Amendment to the RFP or Bid Proposal or Withdrawal of Bid Proposal.

The Division reserves the right to amend the RFP at any time. Any amendment shall be posted to the

Division’s website, and shall be emailed to known potential Bidders. The Bidder shall acknowledge

in its proposal receipt of an amendment. If the amendment occurs after the closing date for receipt of

bid proposals, the Division may, in its sole discretion, allow Bidders to amend their bid proposals in

response to the Division’s amendment if necessary.

The Bidder may amend its bid proposal. The amendment must be in writing, signed by the Bidder

and received by the Division by the time set for the receipt of proposals.

Bidders who submit bid proposals in advance of the deadline may withdraw, modify, and resubmit

bid proposals at any time prior to the deadline for submitting bid proposals. Bidders must notify the

Issuing Officer in writing if they wish to withdraw their bid proposals.


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2.9 Submission of Bid Proposals.

The Division must receive the bid proposal at the offices of the Division before 4:00 p.m., central

time, July 23, 2019. This is a mandatory requirement and will not be waived by the Division. Any

bid proposal received after this deadline will be rejected and returned unopened to the Bidder.

Bidders mailing bid proposals must allow ample mail delivery time to ensure timely receipt of their

bid proposals. It is the Bidder’s responsibility to ensure that the bid proposal is received prior to the

deadline. Postmarking by the due date will not substitute for actual receipt of the bid proposal.

Electronic mail and faxed bid proposals will not be accepted.

The costs of preparation and delivery of the bid proposal are solely the responsibility of the Bidder.

Bidders must furnish all information necessary to evaluate the bid proposal. Bid proposals that fail to

meet the mandatory requirements of the RFP will be disqualified. Verbal information provided by

the Bidder shall not be considered part of the Bidder’s proposal.

2.10 Bid Proposal Opening.

The Division will open bid proposals at 10:00 a.m., central time, July 24, 2019. The bid proposals

will remain confidential until the Evaluation Committee has reviewed all of the bid proposals

submitted in response to this RFP and the Division has announced a notice of intent to award a

contract.

2.11 Rejection of Bid Proposals.

Notwithstanding anything to the contrary in this RFP, the Division reserves the right to reject any or

all bid proposals, in whole or in part, received in response to this RFP at any time prior to the

execution of a written contract. Issuance of this RFP in no way constitutes a commitment by the

Division to award a contract.

2.12 Disqualification.

The Division may reject outright and may not evaluate proposals for any one of the following

reasons:

2.12.1 The Bidder contacts any state employee other than the Issuing Officer, except as

otherwise authorized by this RFP.

2.12.2 The Bidder fails to submit a letter of intent to bid.

2.12.3 The Bidder fails to deliver the bid proposal by the due date and time.

2.12.4 The Bidder fails to deliver the cost proposal in a separate envelope.

2.12.5 The Bidder’s response limits the rights of the Division.


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2.12.6 The Bidder fails to respond to the Division’s request for information, documents, or

references.

2.12.7 The Bidder fails to include any signature, certification, authorization, stipulation,

disclosure or guarantee requested in Section 4 of this RFP.

2.12.8 The Bidder presents the information requested by this RFP in a format inconsistent

with the instructions of the RFP.

2.13 Nonmaterial and Material Variances.

The Division reserves the right to waive or permit cure of nonmaterial variances in the bid proposal

if, in the judgment of the Division, it is in the Division’s best interest to do so. Nonmaterial variances

include minor informalities that do not affect responsiveness, that are merely a matter of form or

format, that do not change the relative standing or otherwise prejudice other Bidders, that do not

change the meaning or scope of the RFP, or that do not reflect a material change in the services. In

the event the Division waives or permits cure of nonmaterial variances, such waiver or cure will not

modify the RFP requirements or excuse the Bidder from full compliance with RFP specifications or

other Contract requirements if the Bidder is awarded the Contract. The determination of materiality is

in the sole discretion of the Division.

2.14 Reference Checks.

The Division reserves the right to contact any reference to assist in the evaluation of the bid proposal,

to verify information contained in the bid proposal and to discuss the Bidder’s qualifications and the

qualifications of any subcontractor identified in the bid proposal.

2.15 Information from Other Sources.

The Division reserves the right to obtain and consider information from other sources concerning a

Bidder, such as the Bidder’s capability and performance under other contracts.

2.16 Verification of Bid Proposal Contents.

The content of a bid proposal submitted by a Bidder is subject to verification. Misleading or

inaccurate responses, in the sole discretion of the Division, shall result in disqualification.

2.17 Bid Proposal Clarification Process.

The Division reserves the right to contact a Bidder after the submission of bid proposals for the

purpose of clarifying a bid proposal to ensure mutual understanding. This contact may include

written questions, interviews, site visits, a review of past performance if the Bidder has provided

goods or services to the Division or any other political subdivision wherever located, or requests for

corrective pages in the Bidder’s bid proposal. The Division will not consider information received if

the information materially alters the content of the bid proposal or alters the type of goods and

services the Bidder is offering to the Division. An individual authorized to legally bind the Bidder


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shall sign responses to any request for clarification. Responses shall be submitted to the Division

within the time specified in the Division’s request. Failure to comply with requests for additional

information may result in rejection of the bid proposal as noncompliant.

2.18 Disposition of Bid Proposals.

All proposals become the property of the Division and shall not be returned to the Bidder. At the

conclusion of the selection process, the contents of all bid proposals will be in the public domain and

be open to inspection by interested parties subject to the exceptions provided in Iowa Code Chapter

22 (2019) or other applicable law.

2.19 Public Records and Requests for Confidential Treatment.

The Division may treat all information submitted by a Bidder as public information following the

conclusion of the selection process unless the Bidder properly requests that information be treated as

confidential at the time of submitting the bid proposal. The Division’s release of information is

governed by Iowa Code Chapter 22 (2019). Bidders are encouraged to familiarize themselves with

Chapter 22 before submitting a proposal. The Division will copy public records as required to

comply with the public records laws.

Any request for confidential treatment of information must be included in the transmittal letter with

the Bidder’s bid proposal. In addition, the Bidder must enumerate the specific grounds in Iowa Code

Chapter 22 or other applicable law which support treatment of the material as confidential and

explain why disclosure is not in the best interest of the public. The request for confidential treatment

of information must also include the name, address, and telephone number of the person authorized

by the Bidder to respond to any inquiries by the Division concerning the confidential status of the

materials. All information submitted by a Bidder may be treated as public information by the IID

unless the Bidder properly requests that information be treated as confidential at the time of

submitting the information. A Form 221 shall be completed by the Bidder and submitted with the

Bidder’s response to the RFP.

Any bid proposal submitted which contains confidential information must be conspicuously marked

on the outside as containing confidential information, and each page upon which confidential

information appears must be conspicuously marked as containing confidential information.

Identification of the entire bid proposal as confidential may be deemed non-responsive and disqualify

the Bidder.

If the Bidder designates any portion of the bid proposal as confidential, the Bidder must submit one

copy of the bid proposal from which the confidential information has been excised. This excised

copy is in addition to the number of copies requested in Section 4 of this RFP. The confidential

material must be excised in such a way as to allow the public to determine the general nature of the

material removed and to retain as much of the bid proposal as possible.

1 Form 22 can be found at https://das.iowa.gov/sites/default/files/procurement/pdf/Form22-RFP.pdf.

https://das.iowa.gov/sites/default/files/procurement/pdf/Form22-RFP.pdf

https://das.iowa.gov/sites/default/files/procurement/pdf/Form22-RFP.pdf


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The Division will treat the information marked confidential as confidential information to the extent

such information is determined confidential under Iowa Code Chapter 22 by the Division. If a Bidder

disagrees with the Division’s decision about confidentiality, the Bidder may appeal the decision

pursuant to 191 Iowa Administrative Code Chapter 3.

In the event the Division receives a request for information marked confidential, written notice shall

be given to the Bidder seven calendar days prior to the release of the information to allow the Bidder

to seek injunctive relief pursuant to Iowa Code section 22.8 (2019).

The Bidder’s failure to request confidential treatment of material will be deemed by the Division as a

waiver of any right to confidentiality which the Bidder may have had.

2.20 Copyrights.

By submitting a bid proposal, the Bidder agrees that the Division may copy the bid proposal for

purposes of facilitating the evaluation of the bid proposal or to respond to requests for public records.

The Bidder consents to such copying by submitting a bid proposal and warrants that such copying

will not violate the rights of any third party. The Bidder shall indemnify, defend, and hold harmless

the Division for any claims or losses related to the Division copying, in whole or in part, the bid

proposal. The Division shall have the right to use ideas or adaptations of ideas that are presented in

the bid proposals.

2.21 Release of Claims.

By submitting a bid proposal, the Bidder agrees that it will not bring any claim or cause of action

against the Division or the State of Iowa based on any misunderstanding concerning the information

provided herein or concerning the Division’s failure, negligent or otherwise, to provide the Bidder

with pertinent information as intended by this RFP.

2.22 Evaluation of Bid Proposals Submitted.

Bid proposals that are timely submitted and that are not subject to disqualification will be reviewed in

accordance with Section 5 of the RFP. The Division will not necessarily award any Contract

resulting from this RFP to the Bidder offering the lowest cost to the Division. Instead, the Division

will award the Contract to the Bidder whose proposal receives the most points in accordance with the

evaluation criteria set forth in Section 5 of this RFP and subject to approval of the Evaluation

Committee.

2.23 Award Notice and Acceptance Period.

Notice of intent to award the Contract to the Vendor will be sent by email by July 30, 2019, to all

Bidders submitting a timely bid proposal. Negotiation and execution of the Contract shall be

completed no later than August 7, 2019. If the apparent successful Bidder fails to negotiate and

deliver an executed Contract by August 7, 2019, the Division may cancel the award and award the

Contract to the next-highest-ranked Bidder.


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2.24 Definition of Contract.

The full execution of a written contract shall constitute the making of a contract for services and no

Bidder shall acquire any legal or equitable rights relative to the those services that the Vendor shall

be required to perform pursuant to the Contract until the Contract has been fully executed by the

Vendor and the Division. In case of conflict, the order of preference of control is that the contract

controls, then the RFP, then the proposal.

2.25 Choice of Law and Forum.

This RFP and the resulting Contract are to be governed by the laws of the State of Iowa. Changes in

applicable laws and rules may affect the award process or the resulting contract. Bidders are

responsible for ascertaining pertinent legal requirements and restrictions. Any and all litigation or

actions commenced in connection with this RFP shall only be brought in Polk County District Court,

Des Moines, Iowa. However, litigation or actions commenced in connection with this RFP may be

brought in the United States District Court for the Southern District of Iowa, Des Moines, Iowa only

when Polk County District Court does not have jurisdiction and jurisdiction is only appropriate in

United States District Court.

2.26 Restriction on Gifts and Activities.

Iowa Code Chapter 68B (2019) restricts gifts which may be given or received by state employees and

requires certain individuals to disclose information concerning their activities with state government.

Bidders are responsible to determine the applicability of this Chapter to their activities and to comply

with the requirements. In addition pursuant to Iowa Code section 722.1 (2019), it is a felony offense

to bribe or attempt to bribe a public official.

2.27 Objections.

The Division reserves the right to accept or reject any exception taken by a Bidder to the terms and

conditions of this Request for Proposals.

Section 3: Service Requirements

3.1 Introduction.

3.1.1 Background.

The structural problems of the Affordable Care Act2 (the “ACA”) caused a collapse of

Iowa’s individual health insurance market. A number of factors contributed to the

skyrocketing premium costs and marked increase in the number of uninsured individuals.

2 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended by the federal Health Care and Education

Reconciliation Act of 2010, Pub. L. No. 111-152, and any amendments thereto, or other applicable federal law


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This background is intended to serve as a brief overview of the history of the market and

its current status.

Prior to the ACA, Iowa had a stable individual market with some of the lowest premium

levels in the nation and many health insurance options to choose from. Nearly 66 percent of

Iowans had access to employer-sponsored insurance. Iowa has a population just above 3

million.

While Iowa had one of the lowest uninsured rates in the country due to the large segment of

the population receiving employer-sponsored coverage, comprehensive health insurance

was unaffordable for many lower- to moderate-income earners. There were challenges in

the individual market, with consumers still being subject to rate increases, condition

exclusions, and coverage denials.

While the number of uninsured individuals in Iowa has decreased with the advent of the

ACA, the number of Iowans actually purchasing policies in the individual market has also

decreased. This reduction in the number of uninsured is largely due to Medicaid expansion

implemented by Iowa. The program, known as the Iowa Health and Wellness Plan,

provides coverage to nearly 150,000 low-income, childless adults.

Iowa’s individual commercial health insurance market consists of grandfathered plans,

transition plans, and ACA-compliant plans.

Beginning in 2015, the age band restriction and subsidy structure disadvantaged healthy

young moderate-income individuals, attracting significantly fewer healthy young participants

into the market than expected. However, the subsidy structure attracted a significantly larger

proportion of 55-64 year-old individuals than expected, causing substantial market losses, due

to the higher costs for healthcare utilization of this population.

Iowa’s individual ACA-compliant market continued to deteriorate as claims and costs

exceeded premiums. Two carriers, Wellmark and Medica, currently offer ACA-compliant

plans in Iowa in 2019.

It is expected that the premium rates under the ACA will price out nearly all individuals

currently on the individual health insurance market except for those who are federally

subsidized or those who must incur these steep costs to ensure health insurance coverage

for their serious illnesses or medical conditions.

3.1.2 Grant.

Iowa has been awarded federal grant funding3 to explore access to coverage under Section

2702 of the Public Health Service Act regarding Guaranteed Availability of Coverage.

Reference Appendices A and B. The IID has issued this RFP to procure the services of

consultants to develop a market analysis/market scan to improve and expand the number of

3 The State Flexibility to Stabilize the Market Grant Program.


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current healthcare coverage options. This market analysis/market scan will provide detailed

simulation modeling to refine current estimates of the population that will access coverage in

Iowa.

3.1.2.1 All entities utilizing federal funds must comply with Title VI of the Civil Rights Act

of 1964. No person in the United States shall, on the ground of race, color, or national

origin, be excluded from participation in, be denied the benefits of, or be subjected to

discrimination under any program or activity receiving Federal financial assistance.

42 U.S.C. 2000d.

3.1.2.2 For any publications, press announcements, posters, oral presentations at meetings,

seminars, and any other information-dissemination format, including but not limited to

electronic/digital media that utilize grant funds the following disclaimer language

must be included:

The project described was supported by Funding Opportunity PR-PRP-

18-001 from the U.S. Department of Health & Human Services, Centers

for Medicare & Medicaid Services. The contents provided are solely the

responsibility of the authors and do not necessarily represent the official

views of HHS or any of its agencies.

3.2 Scope of Work.

The Bidder must demonstrate an ability to provide the following services in accordance with the

defined performance criteria set forth in this RFP.

3.2.1. Obtain and Analyze the Iowa Individual Health Insurance Market and Provide Reports.

The Bidder must demonstrate an ability to obtain and analyze information and to provide

reports. This includes but is not limited to demonstrating it can perform all of the following:

3.2.1.1 Engage in methods that identify sources and types of health coverage.

Methods utilized may consist of in-depth interviews, focus groups, online

communities, mystery shopping, online surveys, telephone interviews, face-to-

face surveys, workshops, and questionnaires.

3.2.1.2 Engage in methods that identify market migration and the population that is

currently insured, has previously been insured or has never had health

coverage insurance, duration of periods of health coverage or non-coverage,

influences on health coverage decisions; and that identify other demographic

information.

3.2.1.3 Provide monthly status reports to the Division, to the attention of Angela

Burke Boston, whose contact information is: telephone (515) 281-4119; email

[email protected].

mailto:[email protected]


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3.2.2. Comply with Additional Requirements Regarding Analysis.

The Bidder must demonstrate an ability to comply with the Division’s additional requirements

regarding the analysis. This includes but is not limited to all of the following:

3.2.2.1 Vendor shall not construe this analysis as a market conduct examination of a

specific insurer or group of insurers.

3.2.2.2 Vendor shall comply with all applicable federal and State of Iowa laws and

rules.

3.2.2.3 Vendor shall have access to private and confidential data maintained by the

State to the extent required to carry out the duties and responsibilities defined

in this agreement and agrees to maintain confidentiality and security of the

data made available.

3.2.2.4 Vendor shall recommend to the Division methods and processes to collect

data, including suggested language for any data call or guidance issued to

insurers.

3.2.2.5 Vendor may utilize additional reports in the possession of the Division

including but not limited to financial data included in insurer annual

statements.

3.2.3. Comply with Grant Service Requirements.

The Bidder must demonstrate an ability to comply with the service requirements of the federal

grant, as set forth in Sections 3.1.2.1 and 3.1.2.2.

3.3 Support and Meetings.

For purposes of preparing a bid, a Bidder should incorporate knowledge and understanding of the

Division’s expectations as set forth in this paragraph. The Division may assist the Vendor in

obtaining necessary data. The Division may request in-person meetings with the Vendor at mutually

agreeable times and places. Support and meetings may be by telephone if the parties mutually agree

in writing. Vendor will provide all copies of materials, manuals, guides and other materials needed

for the training. Vendor’s travel and other expenses related to the meetings and support will be borne

by Vendor, so should be included in the Bidder’s Proposal.

3.4 Deliverables.

Bidder shall provide a proposed schedule for performing the following, in accordance with this RFP

(not necessarily in this order):


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3.4.1 Provide complete detailed simulation modeling to refine current estimates of the population

that will access coverage in Iowa. This will provide a more specific profile of uninsured and

eligible populations.

3.4.2 Conduct analysis to explore possible coverage alternatives permitted under current law.

3.4.3 Provide complete detailed simulation modeling to refine current estimates of population ages

21-40 to determine access to health insurance coverage to inform future process changes

needed to stabilize market.

3.4.4 Provide complete assessment of insurance market in Iowa to better understand enrollment in

the individual market, including demographics to inform planning process.

3.4.5 Conduct a study of the insurance market issues where the population age 21-40 obtains health

insurance coverage.

3.4.6 Conduct a study to identify the following, including but not limited to: the largest

demographic group (by age) that has left the ACA marketplace; the number of Iowans that

have obtained other types of health-related policies such as short-term hospital indemnity,

dread disease; the number of Iowans that have obtained coverage through health sharing

ministries; the number of Iowans with group coverage through small employer group plans;

the number of Iowans currently completely uninsured; the efforts or changes necessary that

individuals have taken or will need to take to return to the individual market, if previously

covered.

3.5 Industry Standards.

Services rendered pursuant to a Contract resulting from this RFP shall be performed in a professional

and workmanlike manner in accordance with the terms of the Contract and the standards of

performance considered generally acceptable in the industry for similar tasks and projects. In the

absence of a detailed specification for the performance of a portion of the Contract, the parties agree

that the applicable specification shall be the generally accepted industry standard.

3.6 Monitoring Plan.

The Vendor shall provide monthly reports as set forth in section 3.2.1.3 of this RFP. The Division

also shall review the details of the monthly invoices to determine the Vendor’s performance. The

Bidder shall provide a proposal for any additional methods that the Division might use to monitor the

Vendor’s progress in providing the services required under this RFP.

3.7 Performance Review Plan.

The Division shall review and evaluate the performance of Vendor at the end of the Contract term,

including evaluation of the efficiency and quality of Vendor’s work, specifically determining

whether:


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3.7.1 100% of the requirements of the Contract were met;

3.7.2 All reports required from Vendor in the Contract were submitted on a timely basis, unless an

extension was granted by the Division in writing;

3.7.3 Vendor attended all meetings required pursuant to the Contract, unless delayed or waived by

the Division in writing; and

3.7.4 Vendor adhered to all confidentiality requirements pursuant to the Contract.

3.8 Maximum Allowable Cost.

Vendor will be paid for the services described in Section 3, including all out-of-pocket expenses and

administrative costs of Vendor, and as described in Section 4.3, after the services have been

performed or expenses or costs have been incurred. Vendor shall submit monthly invoices that

comply with all applicable Iowa laws and rules concerning payment of such claims.

In no event, shall the maximum allowable cost exceed $225,000.00.

SECTION 4: ADMINISTRATIVE INFORMATION

4.1 Instructions.

These instructions prescribe the format and content of the bid proposal. They are designed to

facilitate a uniform review process. Failure to adhere to the proposal format may result in the

disqualification of the bid proposal.

4.1.1 The bid proposal shall be printed on 8.5” x 11” paper.

4.1.2 The bid proposal must be divided into two parts: (1) the Technical Proposal and (2) the Cost

Proposal. One original and five copies of each part, plus one electronic version of each part in

Word format, shall be submitted. Each part of the bid proposal shall be sealed in an envelope,

Technical Proposal separate from Cost Proposal, each appropriately labeled and also labeled

with the RFP title, the Division’s address and the Bidder’s name and address. The original

and five copies of the Technical Proposal may be submitted in one envelope and the original

and five copies of the Cost Proposal may be submitted in another envelope, with one storage

device containing the electronic versions of each part submitted in the envelope with the Cost

Proposal.

4.1.3 If the Bidder designates any information in its proposal as confidential pursuant to Section

2.19, the Bidder also must submit one copy of the bid proposal from which confidential

information has been excised. The confidential material must be excised in such a way as to

allow the public to determine the general nature of the material removed and to retain as much

of the bid proposal as possible.


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4.1.4 If a Bidder proposes more than one method of meeting these requirements (i.e., more than one

bid proposal), each must be labeled and submitted separately. Each will be evaluated

separately.

4.2 Technical Proposal.

The following documents and responses shall be included in the bid proposal in the order given

below.

4.2.1 Transmittal Letter.

An individual authorized to legally bind the Bidder shall sign the transmittal letter. The letter

shall include the Bidder’s mailing address, electronic mail address, fax number, and telephone

number. Any request for confidential treatment of information shall be included in the

transmittal letter in addition to the specific statutory basis supporting the request and an

explanation why disclosure of the information is not in the best interest of the public. The

transmittal letter shall also contain the name, address and telephone number of the individual

authorized to respond to the Division about the confidential nature of the information.

4.2.2 Table of Contents.

The Bidder shall include a table of contents of its bid proposal, referring to page numbers of

the contents.

4.2.3 Executive Summary.

The Bidder shall prepare an executive summary and overview of the services it is offering,

including all of the following information:

4.2.3.1 Statements that demonstrate that the Bidder understands and agrees with the

terms and conditions of the RFP and with standard State of Iowa service

contract terms (See section 6.1).

4.2.3.2 A vision and mission statement for this Project.

4.2.3.3 An overview of the Bidder’s plans for the service requirements in Section 3 of

the RFP.

4.2.3.4 A demonstration of the Bidder’s knowledge of how to perform the service

requirements in Section 3 of the RFP.

4.2.4 Service Requirements.

The Bidder shall address each service requirement in Section 3 of the RFP and explain how it

plans to approach each requirement. Proposals must be fully responsive to service

requirements. Merely repeating the requirements will be considered non-responsive and may


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disqualify the Bidder. Proposals must identify any deviations from the requirements of this

RFP or requirements the Bidder cannot satisfy and reasons it cannot. Any deviations from the

requirements of the RFP or any requirement of the RFP that the Bidder cannot satisfy may

disqualify the Bidder.

4.2.5 Monitoring Plan.

See section 3.6.

4.2.6 Performance Review Plan.

See section 3.7.

4.2.7 Background Information.

The Bidder shall provide the following general background information:

4.2.7.1 Name, address, telephone number, fax number and email address of the Bidder

including all d/b/a’s, assumed names or other operating names of the Bidder;

4.2.7.2 Form of business entity, i.e., corporation, partnership, proprietorship, limited

liability company, etc.;

4.2.7.3 State of incorporation, state of formation, or state of organization;

4.2.7.4 Number of employees;

4.2.7.5 Type of business;

4.2.7.6 Name, address and telephone number of the Bidder’s representative to contact

regarding all contractual and technical matters concerning this proposal;

4.2.7.7 Name, address and telephone number of the Bidder’s representative to contact

regarding scheduling and other arrangements;

4.2.7.8 Name and qualifications of any subcontractors who will be involved with this

Project; and

4.2.7.9 The successful Bidder will be required to register to do business in Iowa and, if

already registered, will provide the date of the Bidder’s registration to do

business in Iowa and the name of the Bidder’s registered agent.

4.2.8 Experience.

The Bidder must provide the following information regarding its experience:


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4.2.8.1 Number of years in business;

4.2.8.2 Number of years of experience with providing the types of services sought by

the RFP;

4.2.8.3 A description of the level of technical experience in providing the types of

services sought by the RFP;

4.2.8.4 A list of all services similar to those sought by this RFP that the Bidder has

provided to other businesses or governmental entities; and

4.2.8.5 Letters of reference from three previous clients knowledgeable of the Bidder’s

performance in providing services similar to the services described in this RFP,

and a contact person, telephone number and email address for each reference.

4.2.9 Personnel.

4.2.9.1 The Bidder must provide a description of its in-house expertise, and include

resumes for all key personnel who will be involved in providing the services

contemplated by this RFP. The following information must be included in the

resumes:

4.2.9.1.1 Full name;

4.2.9.1.2 Education; and

4.2.9.1.3 Years of experience and employment history particularly as it relates to

the scope of services specified herein.

4.2.9.2 The Bidder must provide a description of the level of reliance it plans to place

on outside entities to provide services related to any Contract resulting from

this RFP. If a relationship with any outside service provider would be utilized,

please describe the Bidder’s relationship with all such service providers.

4.2.10 Terminations, Litigation.

The Bidder must provide the following information:

4.2.10.1 Whether, during the last five years, the Bidder has had a contract for services

terminated for any reason and, if so, full details related to the termination.

4.2.10.2 Whether, during the last five years, the Bidder has had or been threatened with

litigation, administrative or regulatory proceedings, or similar matters that

could affect the ability of the Bidder to perform the required services and, if so,

full details. The Bidder must also state whether it or any owners, officers, or

primary partners have ever been convicted of a felony. Failure to disclose


20

these matters may result in rejection of the bid proposal or in termination of

any subsequent contract. This is a continuing disclosure requirement. Any

such matter commencing after submission of a bid proposal and with respect to

the successful Bidder after the execution of a contract must be disclosed in a

timely manner in a written statement to the Division.

4.2.11 Proposal Certification.

The Bidder shall sign and submit with the bid proposal the document included as Attachment

A, in which the Bidder shall certify that the contents of the bid proposal are true and accurate.

4.2.12 Acceptance of Terms and Conditions.

The Bidder shall specifically agree that the bid proposal is predicated upon the acceptance of

all terms and conditions stated in the RFP. If the Bidder objects to any term or condition, the

Bidder must specifically refer to the RFP page and section. Objections or responses that

materially alter the RFP may be deemed non-responsive and disqualify the Bidder.

4.2.13 Certification of Independence and No Conflict of Interest.


B, in which the Bidder shall certify that it developed the bid proposal independently. The

Bidder shall also certify that no relationship exists or will exist during the contract period

between the Bidder and the Division that interferes with fair competition or is a conflict of

interest. The Division reserves the right to reject a bid proposal or cancel the award if, in its

sole discretion, any relationship exists that could interfere with fair competition or conflict

with the interests of the Division.

4.2.14 Release of Information.


C in which the Bidder authorizes the release of information to the Division.

4.2.15 Firm Bid Proposal Terms.

The Bidder shall guarantee in writing the availability of the services offered and that all bid

proposal terms, including price, will remain firm a minimum number of 30 days following the

deadline for submitting proposals.

4.3 Cost Proposal.

The Bidder shall provide its proposal for costs it will be charging for the proposed services.

4.3.1 The amounts should be for the Contract term, August 8, 2019 through July 30, 2020.


21

4.3.2 The Cost Proposal shall provide sufficient detail so as to allow the Division to ascertain the

cost of each item and each step in the Project, and to allow the Division to determine whether

all aspects of the Technical Proposal are necessary, considering the cost.

4.3.3 Bidders should include in their cost proposals an amount sufficient to successfully complete

all requirements as set forth in the RFP, including any necessary travel expenses by either

party or by associated agencies or volunteers. Bidder will provide all copies of materials,

manuals, guides, and other materials, including any needed AV equipment such as an

overhead projector, laptop, laptop projector, transparencies, flip charts and markers, and any

computer software, hardware or programs necessary to perform the work proposed.

4.3.4 If any materials necessary to successfully complete this Project are required from the

Division, including any need for the Division’s staff time outside of the review and approval

process, those needs and associated costs should be included and explained in the bid

proposal.

4.3.5 In no event, shall the maximum allowable cost exceed $225,000.00.

4.3.6 Unless otherwise agreed in writing by the parties, the Bidder shall not be entitled to receive

any other payment or compensation from the State for any goods or services provided by or

on behalf of the Bidder under this RFP or from any Contract resulting from this RFP. The

Bidder shall be solely responsible for paying all costs, expenses and changes it incurs in

connection with its performance under this RFP or from any Contract resulting from this RFP.

SECTION 5: EVALUATION OF BID PROPOSALS

5.1 Introduction.

5.1.1 This section describes the evaluation process that will be used to determine which bid

proposal provides the greatest benefits to the Division. The evaluation process is designed to

award the contract – not necessarily to the Bidder of least cost, but rather, to the Bidder with

the best combination of attributes to perform the required services.

5.1.2 The evaluation and award process shall consist of the following:

5.1.2.1 Review of the bid proposals to assess compliance with mandatory

requirements;

5.1.2.2 Detailed evaluation of proposed services, programs, and solutions;

5.1.2.3 Scoring of technical proposals;

5.1.2.4 Scoring of cost proposals;


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5.1.2.5 Integration of technical score and cost score into an Evaluation Committee

recommendation to the Iowa Insurance Commissioner; and

5.1.2.6 Award decision by the Iowa Insurance Commissioner.

5.2 Evaluation Committee.

The Division intends to conduct a comprehensive, fair and impartial evaluation of bid proposals

received in response to the RFP. The Division will use an Evaluation Committee consisting of

Division staff members to review and evaluate the proposals.

5.3 Evaluation Criteria.

The Evaluation Committee will evaluate and score all proposals meeting all mandatory requirements.

A weighted scoring system will be used. The weighted scoring system will provide numerical scores

that represent the Committee’s assessment of the relative merits of the bid proposals. A copy of the

evaluation scoring sheet will be provided at the Bidders’ Conference. The Evaluation Committee

will evaluate all proposals and make an award using the following criteria:

5.3.1 Experience and number of years the Bidder has been in the business of providing the required

types of products/services, and financial stability of the Bidder’s organization;

5.3.2 Responsiveness to the requirements of the Project as set forth in this RFP;

5.3.3 Demonstration of understanding of the goals and objectives of this Project and a logical plan

for providing products or services within the required time frames;

5.3.4 The written description of the system for security of records;

5.3.5 Agreement to the State of Iowa’s general service contract terms (see section 6.1);

5.3.6 Price; and

5.3.7 References from the Bidder’s clients.

5.3.8 In the event of a tie, preference will be given to a Bidder certified as a targeted small business

program as defined in Iowa Code section 15.102(10). See Iowa Code sections 15.108(1) and

73.20; Iowa Administrative Code rules 11—117.6(7), and 15—73.16, —73.19, and –73.20.

5.3.9 In the event of a tie, preference will be given to a business that is Iowa-based. Iowa

Administrative Code rule 11—117.6(2).


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5.4 Recommendation of the Evaluation Committee.

The final ranking and recommendation of the Evaluation Committee shall be presented to the Iowa

Insurance Commissioner for consideration. This recommendation may include the name of one

Bidder recommended for selection or a recommendation that no Bidder be selected. The Iowa

Insurance Commissioner will select the Bidder to receive the award. The Iowa Insurance

Commissioner is not bound by the Committee’s recommendation. All Bidders submitting proposals

will receive either a written acceptance or rejection of the proposal submitted.

SECTION 6: CONTRACT TERMS AND CONDITIONS.

6.1 Contract Terms and Conditions.

The contract that the Division expects to award as a result of this RFP will be based upon the bid

proposal submitted by the Vendor and this solicitation. The Contract between the Division and the

Vendor shall be a combination of the specifications, terms and conditions of the RFP, the offer of the

Vendor contained in the technical and cost proposals, written clarifications or changes made in

accordance with the provisions herein, and any other terms deemed necessary by the Division.

Sample terms for service contracts with the State of Iowa are available at

https://das.iowa.gov/sites/default/files/procurement/pdf/050116%20terms%20services.pdf. The

contract terms contained in the sample contract are not intended to be a complete listing of all

contract terms but are provided only to enable Bidders to better evaluate the costs associative with the

RFP and the potential resulting contract. Bidders should plan on such terms being included in any

contract awarded as a result of this RFP. All costs associated with complying with these

requirements should be included in the cost proposal or any pricing quoted by the Bidder.

By submitting a proposal, each Bidder acknowledges its acceptance of these specifications, terms and

conditions without change except as otherwise expressly stated in its proposal. If a Bidder takes

exception to a provision, it must state the reason for the exception and set forth in its proposal the

specific contract language it proposes to include in place of the provision. Exceptions that materially

change these terms or the requirements of the RFP may be deemed non-responsive by the Division, in

its sole discretion, resulting in possible disqualification of the proposal. The Division reserves the

right to either award a contract without further negotiation with the successful Bidder or to negotiate

contract terms with the selected Bidder if the best interests of the Division would be served.

6.2 Contract Length.

The term of the Contract will commence on August 8, 2019 and end on July 30, 2020.

https://das.iowa.gov/sites/default/files/procurement/pdf/050116%20terms%20services.pdf


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ATTACHMENT A

Ann Outka


Two Ruan Center



RE: Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market pursuant to

State Flexibility to Stabilize the Market

RFP 19216-04

PROPOSAL CERTIFICATION

Dear Ms. Outka:

I certify that the contents of the proposal submitted on behalf of the undersigned bidder in response to

the Iowa Insurance Division’s Request for Proposals for Market Scan of the Iowa Individual Health

Insurance Market pursuant to State Flexibility to Stabilize the Market, RFP 19216-04, are true and

accurate. I also certify that the undersigned bidder has not knowingly made any false statements in

its proposal.

Sincerely,

____________________________________

Name

____________________________________

Title

For _________________________________

Bidder

____________________________________

Date


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ATTACHMENT B

Ann Outka


Two Ruan Center



RE: Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market pursuant to

State Flexibility to Stabilize the Market

RFP: RFP 19216-04

CERTIFICATION OF INDEPENDENCE AND NO CONFLICT OF INTEREST

Dear Ms. Outka:

By submitting a proposal in response to the Iowa Insurance Division’s Request for Proposals for Market

Scan of the Iowa Individual Health Insurance Market pursuant to State Flexibility to Stabilize the Market

(“RFP”), the undersigned certifies the following:

1. The proposal has been developed independently, without consultation, communication or agreement

with any employee or consultant to the Division who has worked on the development of this RFP, or

with any person serving as a member of the evaluation committee.

2. The proposal has been developed independently, without consultation, communication or agreement

with any other bidder or parties for the purpose of restricting competition.

3. Unless otherwise required by law, the information found in the proposal has not been knowingly

disclosed and will not be knowingly disclosed prior to the award of the contract, directly or

indirectly, to any other bidder.

4. No attempt has been made or will be made by the undersigned Bidder to induce any other bidder to

submit or not to submit a proposal for the purpose of restricting competition.

5. No relationship exists or will exist during the contract period between the undersigned Bidder and the

Division that interferes with fair competition or as a conflict of interest.

Sincerely,

____________________________________

Name

____________________________________

Title

For _________________________________

Bidder

____________________________________

Date


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ATTACHMENT C

Ann Outka


Two Ruan Center



RE: Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market pursuant to State

Flexibility to Stabilize the Market

RFP 19216-04

AUTHORIZATION TO RELEASE INFORMATION

Dear Ms. Outka:

The undersigned Bidder hereby authorizes the Iowa Insurance Division (“Division”) to obtain information

regarding its performance on other contracts, agreements or other business arrangements, its business

reputation, and any other matter pertinent to the evaluation and the selection of a successful bidder in response

to the Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market pursuant to State

Flexibility to Stabilize the Market.

The Bidder acknowledges that it may not agree with the information and opinions given by such person or

entity in response to a reference request. The Bidder acknowledges that the information and opinions given by

such person or entity may hurt its chances to receive contract awards from the Division or may otherwise hurt

its reputation or operations. The Bidder is willing to take that risk.

The Bidder hereby releases, acquits and forever discharges the State of Iowa, the Division, their officers,

directors, employees and agents from any and all liability whatsoever, including all claims, demands and causes

of action of every nature and kind affecting the undersigned Bidder that it may have or ever claim to have

relating to information, data, opinions, and references obtained by the Division in the evaluation and selection

of a successful bidder in response to Request for Proposals for Market Scan of the Iowa Individual Health

Insurance Market pursuant to State Flexibility to Stabilize the Market.

The Bidder authorizes representatives of the Division to contact any and all of the persons, entities, and

references which are, directly or indirectly, listed, submitted, or referenced in the undersigned’s proposal

submitted in response to Request for Proposals for Market Scan of the Iowa Individual Health Insurance Market

pursuant to State Flexibility to Stabilize the Market.

The Bidder further authorizes any and all persons and entities to provide information, data, and opinions with

regard to the undersigned’s performance under any contract agreement, or other business arrangement, the

undersigned’s ability to perform, the undersigned’s business reputation, and any other matter pertinent to the

evaluation of the undersigned. The undersigned hereby releases, acquits and forever discharges any such

person or entity and their officers, directors, employees and agents from any and all liability whatsoever

including all claims, demands and causes of action of every nature and kind affecting the undersigned that it

may have or ever claim to have relating to information, data, opinions, and references supplied to the Division

in the evaluation and selection of a successful bidder in response to Request for Proposals for Market Scan of

the Iowa Individual Health Insurance Market pursuant to State Flexibility to Stabilize the Market.


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A photocopy or facsimile of this signed Authorization is as valid as an original.

Sincerely,

___________________________________________________

___________________________________________________

Printed Name of Bidder Organization

____________________________________________________

Name and Title of Authorized Representative

____________________

Date


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Appendix A

The State Flexibility to Stabilize the Market Grant Program

Funding Opportunity Number PR-PRP-18-001

Available at https://iid.iowa.gov/documents/rfp-market-stabilization-grant-2019-appendix-a

https://iid.iowa.gov/documents/rfp-market-stabilization-grant-2019-appendix-a


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Appendix B

Iowa State Flexibility to Stabilize the Market Grant Program Project Narrative

Available at https://iid.iowa.gov/documents/rfp-market-stabilization-grant-2019-appendix-b

https://iid.iowa.gov/documents/rfp-market-stabilization-grant-2019-appendix-b

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