The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) may have a continuing requirement to provide Marketplace Operations, Communications, and Quality Assurance Support.

The Patient Protection and Affordable Care Act (Pub. L. 111–148) was enacted on March 23, 2010, to assist millions of Americans in obtaining affordable health care services and to allow more employers to offer health insurance coverage in a cost-effective manner to their employees. The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111–152), which amended and revised several provisions of the Patient Protection and Affordable Care Act, was enacted on March 30, 2010. The two statutes are collectively referred to as the Patient Protection and Affordable Care Act or the “PPACA.” The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with implementing many reforms of the PPACA and oversees the implementation of the provisions related to private health insurance. CCIIO works closely with state regulators, consumers, and other stakeholders to ensure the PPACA best serves the American people. CCIIO is also responsible for establishing and operating a Federally Facilitated Exchange (FFE) and a Federally Facilitated Small Business Health Options Program (FF-SHOP) in any State that does not establish and operate its own Exchange. These exchanges allow consumers to learn about, shop for, and enroll in Qualified Health Plans (QHPs) offered by private health insurance companies operating in their states. Whether operated as FFEs or State-Based Exchanges (SBEs), the Health Insurance Marketplaces serve as one-stop shops where individuals can (1) get information about their coverage options, (2) be assessed for eligibility for the Marketplace, tax credits for private insurance, or programs like the Children’s Health Insurance Program (CHIP), and (3) enroll in the plan of their choice. Small businesses also have the option to purchase insurance through the SHOPs developed by individual states if applicable.

CCIIO manages the oversight of and provides technical assistance to QHP issuers participating in the FFE, including issuers in State Partnership Marketplaces (SPMs). It implements and manages the QHP certification processes and receives and reviews QHP applications. In addition, CCIIO performs related functions such as the management of ongoing QHP data, enrollment, consumer complaints, review of rate increases, and issues related to the certified issuers and their plans. CCIIO also supports various consumer eligibility and enrollment functions including supporting beneficiaries as they switch between different forms of government health insurance.

• CMS seeks the services of a qualified vendor to support Marketplace operations, communications, and quality assurance (MOCQA) support. Communication support includes measuring QHP engagement, messaging, and stakeholder outreach and education. Operations support includes all aspects of Marketplace plan management (i.e., health insurance issuer) operations with a particular emphasis on QHP Certification and plan maintenance as well as the use of customer relationship management (CRM) tools in support of the CCIIO mission. The Contractor will also support CCIIO in developing processes for and performing and documenting quantitative quality assurance (QA) reviews on data and reports to ensure that they are current, accurate, and complete. This task order also calls for the Contractor to support the quality assurance and operations for selected Marketplace eligibility and enrollment functions such as those related to account transfers between Marketplace and Medicaid. Finally, the Contract will support the CCIIO Front Office mission, including but not limited to meeting and communications support for the Marketplace Operations Coordination Center as well as Marketplace data trends analyses.