The Office of Insurance Commissioner (OIC) is initiating this Request for Proposals (RFP) to solicit responses from individuals or Vendors interested in participating on a project to review how Washington state health plans define, cover, and reimburse for maternity care services, including prenatal, delivery, and postpartum care and to provide recommendations to reduce or eliminate deductibles and other forms of cost-sharing for maternity care services. The Contractor will be responsible for determining the potential impacts on multiple types of health plans offered in Washington, with respect to actuarial values and premium rates if coverage for a specific set of benefits were included as directed by Substitute Senate Bill 5581 and section 144(19) of Engrossed Substitute Senate Bill 5187. The Contractor’s duties include assistance with organizing research into maternity cost-sharing reductions or elimination options and supporting a public meetings process.

Contractor selected as a result of this RFP will be required to:

• Assist OIC with data gathering and analysis of commercial health plans offering maternity care services in Washington state.
• Provide actuarial analysis and advice related to options to reduce or eliminate cost-sharing for maternity care services in commercial health plans and public employee health plans offered in Washington state.
• Analyze similar maternity care cost-sharing reduction or elimination policies in other states. 
• Create and submit documentation supporting findings and recommendations for reduction or elimination of cost-sharing for maternity services. 

 Minimum qualifications include:

• Vendor must have previously held at least thirty-six (36) months of responsibilities substantially the same as, or very similar to, the Scope of Work.
• Vendor must be or employ health insurance actuaries who are members of the American Academy of Actuaries and Society of Actuaries and meet the qualification standard to complete the scope of work stated in this RFP. 
• Project team leadership by an individual with at least five (5) years of commercial health insurance rate development or rate review and/or research experience in evaluating health plan cost factors and rating factors. 

Important dates

Aug 21, 2023 Questions due from vendors by 11:59 pm Pacific Time

Aug 29, 2023 OIC will post Q&A addendum

Sep 5, 2023 Preproposal conference at 10:00 am Pacific Tie

Sep 11, 2023 OIC will post final addendum

Oct 2, 2023 Vendor proposals are due to OIC by 11:59 pm Pacific Time

Commodity Codes: 918-32 - Consulting Services, 918-49 - Finance/Economics Consulting, 918-69 - Insurance Consulting, 946-11 - Accounting Services, 946-12 - Actuarial Services, 946-20 - Auditing, 946-49 - Finance Services, 953-52 - Insurance and Insurance Services, 958-39 - Finance Management Services, 958-56 - Health Care Management Services