All correspondence must be made through the Vendor Portal. Specifications include, but are not limited to: Task 1: On-Going Administrative and Actuarial Work to Support the Successful Management of a 1332 Waiver Subtask 1.1 -- Carrier reinsurance and waiver planning. The Vendor will be responsible for creating and executing a detailed plan to assist state administration of the 1332 waiver program including any required reinsurance payments to carriers in each year of the waiver. The plan will minimally include the following with an accompanying timeline: • Process and timeline to update the reinsurance parameters each year based on available funding and claims experience and present the results to the state and to the carriers • Process and timeline for producing data needed by CMS for calculating pass-through funding. • Process and timeline for calculating carrier reimbursements. • Detailed content for data requests for all the above. • Recommended steps for verification of sufficient accuracy and completeness of the data as well as presentation of the methodology, analysis, and reimbursement results to each carrier. • Documentation through final reports. Subtask 1.2 – Assist the state in setting annual reinsurance parameters. In accordance with the state’s accepted version of the detailed plan described above, the Vendor will assist the state in setting annual payment parameters. • This task includes collecting and analyzing preliminary claims data from the previous year and projecting current and upcoming year claims. • The Vendor will propose parameters based on projected claims, state funding, and federal funding. The vendor will provide a range of scenarios to show sensitivity around premium, enrollment, or possible state and federal changes, as appropriate. Once parameters are finalized, the Vendor will provide the state with documentation of analytic methodology included in a final parameters report.
