Covered California Approves IT Contracts, Prepares for CalHEERS Procurement

The board of California’s health benefits exchange has approved Covered California and its state partners to work on activities supporting the re-procurement of the $864 million CalHEERS system.

The California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) system includes the Covered California Web portal that allows Californians to shop for health insurance under the Affordable Care Act, as well as the back-end rules engine that determines eligibility and enrollment processes for the California Health Benefit Exchange, Medi-Cal and Healthy Families programs.

“CalHEERS is in place, will be in place for years to come, but re-procurement is a major ongoing deal and we'll be having a procurement for procurement," Covered California executive director Peter Lee said during a May 12 board meeting.

Covered California in 2012 awarded Accenture a $359 million, five-year contract with three one-year options for initial and ongoing development of CalHEERS. The base term will expire in June 2017.

The California Health Benefit Exchange Board also approved Covered California’s interagency agreement with the Office of Systems Integration and the Department of Health Care Services as the project managers of CalHEERS, Lee said. Day-to-day management and oversight of CalHEERS has moved from Covered California to the Office of Systems Integration (OSI).

Lee also reported:

• The board voted to extend a competitively bid contract with Natoma Technologies supporting Covered California’s Customer Relationship Management system.

• Approved conducting a competitive process to procure systems development consulting.

• Approved extension of our competitively bid contract for readability and translation services with Maximus.

• Approved use of GetInsured, a sole source software vendor, that is the front face for consumers' experience in CalHEERS.

"We're excited to note as part of that engagement the Open Enrollment 4, which we call OE4, will have a fresh look — still consumer-centric, still oriented toward our consumers understanding how to make the best choice possible. But we're taking the lessons learned over the last three years, both in California and nationally, to refresh the consumer experience," Lee said.