- Associated Press - Sunday, October 12, 2014

California’s health insurance exchange executed more than 300 contracts with vendors worth roughly $1 billion from late 2010 through July, according to agency records obtained by The Associated Press. Those figures do not include the value of competitively awarded contracts with large health providers, such as MetLife and Kaiser Permanente, which are temporarily shielded from public disclosure by state law.

Contracts with state and government agencies, such as the California Department of Health Care Services, tallied nearly $370 million, and did not require competitive bids. The non-government contracts that were not competitively bid are listed below, along with the time period the contract was in effect and a description of the work to be done, as provided by Covered California.

Non-Competitive Bid Weber Shandwick $98.7 million 5/1/2013 4/30/2015 Implement statewide outreach, education and marketing strategies for insurance affordability programs. Includes additional qualitative research to identify market segments, creative productions, paid and earned media, public relations and digital/social media. Resources include the direct media purchase expenses and are subject to ongoing approval processes.
Non-Competitive Bid Richard Heath Associates $44.3 million 8/1/2013 12/31/2014 Contractor will manage and oversee the outreach and education grant program (including training), the In-Person Assistance Program (including training), and the Navigator program.
Non-Competitive Bid Pinnacle Claims Management, Inc. $14.8 million 4/1/2013 9/30/2016 Amendment is needed for PCMI to support agents assisting enrollees in the individual market including individual agent call center support, sales support and product training for the individual market, sales cycle updates and reporting, and a lead management system. This amendment also includes additional staff for PCMI for manual processing of SHOP applications.
Non-Competitive Bid The Tori Group $4.2 million 3/4/2013 1/31/2015 Consultants to assist with the implementation of SHOP policy and operations.
Non-Competitive Bid Robert Half International, Inc. $3.7 million 5/1/2013 12/31/2014 The consultant will provide technical assistance to develop, design, and implement the Exchange’s premium accounting and reconciliation area which includes compensating assisters and developing and implementing the accounting and cash processes to compensate assisters, and establish proper controls and fraud prevention that will be associated with the implementation of the exchange.
Non-Competitive Bid National Opinion Research Center $3.6 million 8/1/2013 6/30/2015 The contractor will continue and expand research services for the exchange. This research will include qualitative research for small businesses, quantitative research for consumers and ad-hoc research projects as needed to inform the policy decisions of the exchange.
Non-Competitive Bid Health Consumer Alliance/Legal Aid Society of San Diego $3.4 million 5/1/2013 12/31/2014 Health consumer alliance for consumer assistance.
Non-Competitive Bid MAXIMUS, Inc. $1 million 2/3/2014 6/30/2014 The Contractor will provide interim staffing support to perform key data entry work to process paper applications for the exchange’s marketplace into the California Healthcare Eligibility and Enrollment Retention System to ensure applicants are enrolled to receive their benefits. This interim staffing will be retained during open enrollment to assist with any immediate key data entry needs, and for three months after open enrollment ends to provide support of back office duties.
Non-Competitive Bid Robert Half International, Inc. $950,000 7/20/2012 6/30/2013 The consultant will provide technical assistance to develop, design, and implement the exchange’s premium accounting and reconciliation area which includes compensating assisters and developing and implementing the accounting and cash processes to compensate assisters, and establish proper controls and fraud prevention that will be associated with the implementation of the exchange.
Non-Competitive Bid Milliman, Inc. $826,500 1/1/2012 9/30/2013 Review, analyze, assess and provide recommendations on actuarial requirements for the essential health benefits.
Non-Competitive Bid Rideout Advisors, LLC $822,720 7/1/2013 6/30/2015 Under the general direction of the executive director, the contractor will provide a consultant to perform the duties of the exchange’s senior medical adviser until the position can be permanently filled. The consultant will provide consultation and advice regarding the design of policies affecting how the exchange’s policy can best promote wellness and value. The consultant will develop, plan, and advise on implementation of policies that advance and improve the health of Californians and strengthen the health care delivery system.
Non-Competitive Bid Kenneth F. Wood $618,000 12/6/2012 4/29/2014 To provide the exchange with an interim director of product development and sales until that position can be filled.
Non-Competitive Bid Manatt, Phelps & Phillips, LLP $580,000 8/1/2012 12/31/2014 Lead and support internal working meetings of state and exchange staff in affected agencies to identify common issues, options, and possible approaches to coordination with existing state programs, including Medicaid, Healthy Families and Other Applicable State Health Programs and with state health insurance regulating agencies.
Non-Competitive Bid Christopher M. Kelly & Associates $450,000 7/1/2012 8/31/2013 Provide technical consulting services in marketing and developing partnership programs with the exchange in order to optimize the marketing budget and achieve enrollment objectives.
Non-Competitive Bid National Opinion Research Center $350,000 8/1/2012 6/30/2014 To design, develop and implement the exchange’s evaluation plan. Services include data collection, analysis and reporting.
Non-Competitive Bid Pacific Business Group on Health Negotiating Alliance $335,000 10/1/2012 10/31/2013 The contractor will provide eValue8 tool to manage eRFP responses and provide training to Exchange staff.
Non-Competitive Bid Pricewaterhouse Coopers, LLP $300,000 11/1/2012 9/30/2013 To provide specialized consulting services in the area of health plan design, actuarial analysis of plan design, development of dental plan designs to meet the pediatric dental essential health benefit requirements.
Non-Competitive Bid Leah C. Morris $250,000 3/1/2013 8/31/2014 Consulting services to assist in the review of QHP bidder responses and advise staff during final QHP plan selection process.
Non-Competitive Bid Ted Von Glahn $249,506 11/1/2013 12/31/2014 To provide QRS consulting services to the exchange’s senior medical adviser.
Non-Competitive Bid Wakely Consulting Group $241,000 1/18/2013 6/30/2014 Provide technical consulting services to assist the exchange in the development of a financial analysis, in order to support requests on-going federal funding and also make recommendations on the exchange’s financial infrastructure to ensure that the exchange is a self-sustainable organization. The contractor will develop a Financial Sustainability Plan which identifies the necessary funding needed to maintain the exchange’s new programs.
Non-Competitive Bid Ana J. Matosantos $240,000 1/15/2014 12/31/2014 Senior strategy adviser to advise the exchange on the impact and long-term success of the exchange in the areas of financial sustainability, heath care cost containment and evaluations of outcomes and analytics.
Non-Competitive Bid Taylor Feldman Group $210,000 7/1/2014 7/1/2015 Covered California has requested assistance from The Taylor Feldman Group, LLC to provide health analytics consulting services. TFG will assist CC to develop an analytic agenda, build a health care analytic unit, procure and implement necessary warehousing and tools (Enterprise Analytic Solution), and conduct analyses vital to the CC business objectives during the next two years. This work will jump start the CC analytic capabilities and lay the foundation of knowledge, techniques, tools and data for data-driven decision-making.
Non-Competitive Bid ClearBest, Inc. $200,000 3/17/2012 6/30/2012 Post-award evaluation consulting services.
Non-Competitive Bid Pacific Business Group on Health Negotiating Alliance $190,000 7/1/2014 6/30/2015 The purpose of this contract is to support the exchange’s QHP selection, oversight and management activities and obtain access to eValue8, a proprietary health plan request for information (RFI) tool. National Business Council on Health (NBCH) requires users to pay a license fee to access this health plan RFI tool. The contractor will provide consulting services to support the reviewing, scoring and analysis of QHP bidder’s responses to eValue8 questions contained within the QHP application, and consulting services for the management of electronic reports available based on responses to the exchange’s QHP recertification/certification and support a process to select an analytic vendor.
Non-Competitive Bid Bank of America $184,978 12/9/2013 6/30/2015 Contractor shall provide lockbox services to process the premium monies generated by the Small Business Health Options Program (SHOP) for the California Health Benefit Exchange.
Non-Competitive Bid Yolanda R. Richardson $176,500 7/1/2011 4/30/2012 Provide technical consulting services in the design, development, and implementation of eligibility and enrollment processes and functions.
Non-Competitive Bid Powers & Associates $162,650 5/1/2011 12/31/2011 Acting Administrative Officer
Non-Competitive Bid Bertko Actuarial Associates, LLC $153,600 2/1/2014 1/31/2015 The contractor shall act as the exchange’s interim chief actuary/director of research to advise on the impact and long-term success of the exchange in the areas of financial sustainability, health care cost containment and evaluations of outcomes and analytics. The chief actuary/director of research for the exchange will be under the general direction of the executive director and will manage the collection and analysis of data, trend reporting, and market study information needed for the Exchange’s policy development and health plan, population health costs, and risk assessment. The director will be a strategic thinker, team-builder, innovator, and collaborator with an entrepreneurial mindset and strong verbal and written communication skills, who works effectively with diverse stakeholders and fosters diversity, is composed and calm under pressure, and has a passion for the Exchange’s mission.
Non-Competitive Bid McQueen Consulting, LLC $150,000 7/24/2012 12/31/2012 The contractor shall provide four technical consultants in the field of small group segment health care who will assist the exchange’s SHOP exchange director with the following: 1) defining business requirements for the SHOP program; 2) negotiating with carriers to solicit their participation in the program; 3) developing detailed eligibility and enrollment processes for SHOP; and 4) representing the exchange in strategy meetings for the CalHEERS and potentially other projects.
Non-Competitive Bid The TriZetto Group, Inc. $150,000 12/19/2012 6/18/2013 To provide the exchange with the services of a senior medical adviser until the exempt assignment can be filled.
Non-Competitive Bid Helmsman Advisors $150,000 3/25/2013 9/30/2013 Leadership services for the exchanges various contracts, assisting to stand up three service center sites.
Non-Competitive Bid Milliman, Inc. $150,000 11/1/2013 9/30/2014 The contractor shall provide interim actuarial and analytical support services to assist the exchange in the analysis and response to the president’s recommendation to extend the deadline for health insurance companies to discontinue health plans that don’t meet basic standards and evaluate the financial and operational impact to the exchange of proposed changes in federal and/or state policy, regulation or guidance.
Non-Competitive Bid MAXIMUS, Inc. $150,000 12/23/2013 1/31/2014 MAXIMUS will provide the exchange with interim staffing of key data operators to enter paper applications into CalHEERS
Non-Competitive Bid Casey J. Morrigan Associates $148,000 9/1/2012 6/30/2014 The contractor will provide policy analysis and research expertise to the exchange to identify issues that require analysis, research, and resolution by either the exchange staff or its board.
Non-Competitive Bid Sacramento News and Review (Chico Community Publishing, Inc.) $145,091 4/25/2013 12/31/2013 The contractor shall write, design, print and ship to four exchange locations - two in Los Angeles, one in the Bay Area and one in Sacramento - 50,000 copies of an eight-page tabloid newsprint publication, plus provide a media plan and PDF and/or flipbook version. The contractor shall provide one English version and one Spanish version of this publication.
Non-Competitive Bid Pacific Health Consulting Group $140,000 1/1/2012 12/31/2012 Develop a stakeholder process that provides stakeholders the opportunity to engage and provide feedback on critical policy decisions.
Non-Competitive Bid Pricewaterhouse Coopers, LLP $120,000 12/3/2012 3/31/2013 Prepare the solicitation document to obtain the services of a vendor to provide supplemental benefits for the SHOP Exchange. (Dental & Vision)
Non-Competitive Bid Lincoln Crow, LLC $108,000 2/1/2014 5/31/2014 Planning, coordination, reporting for field. To expedite startup and geographic focus, we propose hiring outside two-person consulting team to manage the external coordination and work with internal staff to coordinate Covered California’s efforts. This will be a matrix organization, drawing from various parts of CoCA to ensure the proper expertise and support. The field consultants will bring experience working in insurance, with insurance agent networks, and with the relevant nonprofits organizations, including relationships within their field teams. Additionally, consultants will bring experience managing field organizations across the state. Two person team, one full time shifting down to part time, one part time.
Non-Competitive Bid Center for Healthcare Decisions $106,359 3/1/2012 6/30/2012 Conduct 10 consumer focus groups, plus one pilot. The focus groups will gauge consumer reaction to different approaches to cost-sharing structures in benefit plan design.
Non-Competitive Bid Kelch & Associates $101,702 12/1/2011 7/31/2012 Provide consulting services and assist the exchange in developing solicitation and contractual requirements, vendor selection, and Level II application grant application process.
Non-Competitive Bid Wakely Consulting Group $100,000 3/21/2012 12/31/2012 Research and feasibility analysis to ensure financial self-sufficiency and sustainability of the exchange.
Non-Competitive Bid Kirstin C. Appelt $100,000 10/8/2012 5/31/2013 The contractor will provide technical consulting services in the area of usability and qualified health plan evaluation for the CalHEERS project.
Non-Competitive Bid Weber Shandwick $100,000 3/11/2013 4/30/2013 Consultant services for the exchange’s communications campaign strategy and planning, advertising creative development and production, paid media planning and placement, social media strategy and communications, and collateral material development and production. The contractor shall create and develop an integrated transition campaign plan for Covered California’s marketing program to compliment the work of Ogilvy PR.
Non-Competitive Bid Proposal Technologies Network, Inc. $93,000 10/1/2012 6/30/2013 Use ProposalLink Software to prepare reports about the QHP eRFPs.
Non-Competitive Bid National Association of Insurance Commissioners $84,451 3/10/2014 The exchange requires a license from NAIC to access the System for Electronic Rate and Form Filing, which is the electronic rate filing system used by state insurance companies across the U.S. The exchange is expecting the submission of rates from qualified health plans and standalone dental plans for 2015. This license will streamline the process for rate submission for both the exchange and the issuers.
Non-Competitive Bid Lesley S. Cummings $81,440 8/1/2011 12/31/2011 Assist with policy analysis, provide expertise in specialized areas, and coordinate the California Health Benefit’s Exchange formal review and response on federal regulations.
Non-Competitive Bid Kelch & Associates $80,000 9/19/2012 6/30/2013 The contractor will provide an outside technical consultant to review and draft the grant 2.0 application and documents for review and approval by the federal government.
Non-Competitive Bid Leah C. Morris $78,000 3/1/2012 2/28/2013 The contractor shall assist the exchange in the development of Qualified Health Plan (QHP) certification standards, strategy for health plan solicitation, and final plan selection process. The Contractor will provide timely policy analysis, research, identify issues, make recommendations, and prepare reports and develop an issue matrix, as requested.
Non-Competitive Bid KPMG $64,000 1/21/2014 4/30/2014 The single audit encompasses an audit of California’s financial statements, review of internal controls over financial reporting and compliance with federal program requirements, and additional tests of compliance with federal and state laws and regulations at the entity level and at the major federal program level. California’s single audit is performed in accordance with the Single Audit Act, provisions of OMB Circular A-133, the Government Accountability Office’s Generally Accepted Government Auditing Standards, and the American Institute of Certified Public Accountant’s Statements on Auditing Standards. In order for the exchange to meet federal compliance standards, the audited financial statements (Comprehensive Annual Financial Report (CAFR)) and the single audit on compliance per A-133 must be submitted. In order to complete the audits in such a short time frame, the exchange proposes to engage the contractor to complete the compliance audit, and to perform the financial statement audit. Engaging this contractor is the most expeditious and cost-effective means in which to ensure completion of the audit by March 31, 2014.
Non-Competitive Bid JDJM Group. LLC $64,000 3/10/2014 7/31/2014 Senior budget and finance adviser to advise the exchange on the impact and long-term success of the exchange in the areas of financial sustainability, health care cost containment and evaluations of outcomes and analytics. The contractor will act as the interim chief financial officer until that position can be filled on a permanent basis.
Non-Competitive Tower Watson Delaware, Inc. $61,622 12/1/2010 12/31/2011 Salary survey for executive positions.
Non-Competitive Bid Daniel Chavez $58,000 2/1/2014 5/31/2014 Enrollment organizer will be responsible for the on-the-ground execution of the field plan through a combination of metrics-based program evaluation, coordination of internal and external resources, and relationship building. Organizer will assist matrixed team tasked with outreach to consumers to encourage them to take advantage of the coverage options available to them under the ACA. Organizer will report to the deputy director external affairs. Organizer will coordinate the efforts of a network of community based groups who are providing enrollment assistance and community education to targeted health care consumers on the ACA. Organizer will coordinate groups to play a role in the outreach and enrollment campaign.
Non-Competitive Bid Kelch & Associates $53,750 9/16/2013 12/31/2014 The contractor is an independent health policy research and consulting firm with expertise in commenting and reviewing health care regulations. The contractor will conduct an independent and unbiased review of the exchange’s regulations in order to obtain a different, outside perspective on what the agency creates.
Non-Competitive Bid Rehabilitation and Occupational Consultants $50,000 7/1/2014 6/30/2015 Contractor will provide ergonomic evaluations that will identify significant risk factors, adjust workstations to ergonomic standards and comfort including task chair, keyboard platforms, and desktop equipment. Ergonomic training includes basic posturing and correct support strategies. Contractor will recommend equipment appropriate for staff.
Non-Competitive Bid Tower Watson Delaware, Inc. $48,268 2/1/2012 8/31/2012 Salary survey, executive level positions
Non-Competitive Bid Aanko Technologies, Inc. $43,105 10/4/2013 6/30/2014 To provide additional funds for the contractor to prepare a security/assessment, threat analysis, emergency preparedness information and security/safety committee for the new exchange’s headquarters.
Non-Competitive Bid Proposal Technologies Network, Inc. $43,000 2/1/2014 6/30/2015 The exchange will require the technical support services of the contractor as it collects the submission of individual product offerings for both the individual and small group markets from QHP and SADP issuers starting May 2014. The contractor shall work closely with exchange staff to provide technical consulting services to assist with loading the renewal and new entrant applications, scoring, and plan designs. Other tasks will include linkage to the eValue8 2014 data for key respondents to reuse responses, allowing plans to have linkage to the NBCH-hosted eValue8 2013 data for key respondents (when available) to reuse responses, and manage RFP responses.
Non-Competitive Bid National Committee for Quality Assurance $40,460 6/1/2013 12/31/2014 Data license agreement for QHP to access the Healthcare Effectiveness Data and Information Set (HEDIS).
Non-Competitive Bid Robert Seastrom $35,000 4/1/2013 9/30/2013 Provide the exchange with graphic design support.
Non-Competitive Bid Evolve Partner Group, LLC $34,800 3/8/2013 12/31/2013 Provide organization functional efficiency, compensation structure development, executive meeting analysis, and other organizational development consulting as needed.
Non-Competitive Bid Sjoberg-Evashenk $15,000 9/1/2013 12/31/2013 The contractor shall provide to the California Health Benefit Exchange additional reports related to the salary survey conducted pursuant to the mandates outlined in AB 1602 (Perez, Chapter 655, Statutes of 2010) that enacts the California Patient Protection and Affordable Care Act.
Non-Competitive Bid Sjoberg-Evashenk $15,000 1/1/2014 6/30/2014 The contractor shall provide to the California Health Benefit Exchange additional reports related to the salary survey conducted pursuant to the mandates outlined in AB 1602 (Perez, Chapter 655, Statutes of 2010) that enacts the California Patient Protection and Affordable Care Act.
Non-Competitive Bid Secure Screening Solutions dba Capital Live Scan $14,000 6/1/2014 5/30/2015 Federal guidance requires that state exchanges, like the California Health Benefit Exchange, protect and safeguard customers from unauthorized and illegal access to, or disclosure of, their sensitive information. The contractor will provide the exchange with background checks of CalHEERS contractors.
Non-Competitive Bid Pacific Health Consulting Group $11,000 8/1/2011 10/31/2011 Engage the board, staff and stakeholders in setting the vision and goals of the California Health Benefit Exchange.
Non-Competitive Bid The Tori Group $4,900 12/1/2011 6/30/2012 Provide consulting services to the exchange in order to assist the exchange in its initial design and development of the SHOP program.
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