Oregon Buys #S-X26083-00018359

Actuarial and regulatory consulting for Medicare Advantage and Part D bids

CareOregon is seeking actuarial and regulatory consulting to prepare its Medicare Advantage and Part D bids. - Buyer: CareOregon, Inc., through its Procurement department, on behalf of Health Plan of CareOregon, Inc., doing business as CareOregon Advantage. - Requested service: One Medicare bid consulting engagement covering bid planning, data validation, assumption development, modeling, documentation, certification, and regulatory support. - Prepare one Medicare Advantage and one Part D Bid Pricing Tool (BPT) for the CareOregon Advantage Plus D-SNP (H5859-001). - Provide three formal pricing iterations, plus experience studies, sensitivity analyses, scenario testing, and product, benefit, and formulary strategy support. - Support CMS submission and desk reviews, rebate reallocation, premium rounding, gain/loss testing, and resubmissions; provide organized workpapers and a final bid summary. - A qualified MAAA actuary must provide actuarial certification. Additional plans, BPTs, or iterations may be optional. - Scale: The D-SNP is anticipated to serve approximately 16,000 members for FY 2027. - OEMs and vendors: No OEM or prospective consulting vendor is named. CareOregon Advantage is the health plan, not an identified consulting vendor. - Term: Services cover the calendar-year 2028 bid cycle and comparable renewal-year milestones. The initial term is two years, with renewal options by mutual agreement.

Description

CareOregon, Inc. is seeking a firm to provide actuarial consulting, coordination, modeling, documentation, certification, and regulatory support for its annual Medicare Advantage and Part D bid submissions. The work begins with the calendar year 2028 bid cycle. Proposals must be emailed to vendorservices@careoregon.org; the source states that submissions through OregonBuys will not be accepted. The RFP closing time stated in the attached document is December 1, 2026, at 2:00 PM Pacific Time.

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