Web-Based Premium Billing, Eligibility and Enrollment Platform

The buyer seeks a vendor to provide a web-based premium billing, eligibility, and enrollment platform. The requested scope includes end-to-end enrollment processing both on and off exchange, eligibility ingestion through 834 files for all transaction types, daily cash posting, and revenue reconciliation across state subsidies, abortion credits, and member premiums. Additionally, the platform must handle premium billing operations such as invoicing, proration, refunds, auto-pay, non-payment workflows, suspension, and termination, alongside notice generation, reporting, and system controls. The system must integrate with the agency claims system, merchant services, lockbox payments, and payment channels. Only USA onshore organizations are eligible to apply, and the vendor will perform the work offsite. Bidders must submit questions no later than August 27, 2026. Bidders may submit responses digitally via email or online, and the buyer requests a proposal for the budget.