REQUEST FOR PROPOSALS #2026-06 Medicare Bid Consulting Services

CareOregon, Inc. ("CareOregon") on behalf of Health Plan of CareOregon, Inc. dba CareOregon Advantage, is inviting submission of proposals for the Medicare Bid Consulting Services project.

CareOregon is seeking a firm to provide actuarial consulting, coordination, modeling, documentation, certification, and regulatory support necessary for CareOregon's annual Medicare Advantage and Part D bid submissions, beginning with the calendar year 2028 bid cycle.

The selected Proposer shall provide actuarial consulting, coordination, modeling, documentation, certification, and regulatory support necessary for CareOregon's annual Medicare Advantage and Part D bid submissions, beginning with the calendar year 2028 bid cycle. Services shall be performed in accordance with applicable CMS requirements, instructions, deadlines, and generally accepted actuarial standards of practice. The Proposer shall identify emerging CMS guidance or market developments that may materially affect assumptions, strategy, compliance, or timing.

Bid Planning and Coordination

• Participate in a kickoff meeting to confirm the actuarial scope, key contacts, required inputs, deliverables, and timing.
• Provide a data request identifying the information needed to complete the actuarial work and communicate material gaps or delays.
• Maintain a schedule for the deliverables that aligns with CareOregon's overall bid timeline.
• Provide market analysis identifying discrepancies in benefit design across competitors.

Product Strategy and Bid Development

• Complete one Medicare Advantage BPT and one Part D BPT for CareOregon's D-SNP, using the applicable CMS tools and instructions. Additional plans or BPTs may be added as optional services.
• Provide three formal pricing iterations (preliminary, decision, and final) needed to reach an approvable submission.

Submission, Certification, and CMS Support

• Perform final quality-control review and provide actuarial certification by a Member of the American Academy of Actuaries ("MAAA") who meets CMS qualification standards for certifying the applicable BPTs.
• Support CareOregon's upload and submission activities in Health Plan Management System ("HPMS"), including pre-submission validation and resolution of errors or warnings.
• Lead responses to CMS desk review questions, including revised analyses, documentation, and BPT updates.
• Support rebate reallocation, premium rounding, gain/loss testing, and final resubmissions through CMS approval.

Deliverables and Documentation

• Documented assumptions, methods, data adjustments, validation results, and material limitations.
• Three formal bid-pricing packages with summaries of key results, changes, sensitivities, and decisions needed from CareOregon.
• Final certified Medicare Advantage and Part D BPTs, with required supporting documentation.
• CMS desk review and rebate reallocation analyses, responses, and related correspondence.
• Complete and organized actuarial workpapers sufficient for CareOregon to understand the assumptions, methods, and results.
• A final summary of bid results, material outstanding items, and considerations for the next bid cycle.

**Submission:** All proposals must be emailed to vendorservices@careoregon.org. Do not attempt to submit proposals through or to the OregonBuys website. The subject line of the email must identify the RFP title. Proposal may not exceed a total of 25 pages (single-sided), inclusive of all exhibits, attachments, or other information.

RFP Documents can be downloaded from OregonBuys at https://oregonbuys.gov/bso/. Prospective Proposers are responsible for obtaining any Addenda or answers to clarifying questions from OregonBuys.

Evaluation criteria

| Category | Points available |
| --- | --- |
| Proposer's General Background and Qualifications | 0-20 |
| Scope of Work | 0-50 |
| Equity, Diversity, and Inclusion Efforts | 0-5 |
| Fees | 0-25 |

**Insurance:** Commercial General Liability of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000. Professional Liability of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000. Automobile Liability of not less than $1,000,000 per occurrence. Cyber Liability of not less than $2,000,000 per occurrence. Umbrella coverage in the sum of $2,000,000.

The term of the contract shall be from the effective date through December 31, 2028, with the option for renewals thereafter subject to the mutual agreement of the parties. The fees shall be fixed for the initial term of the contract.