The Vendor is required to provide enrollment and premium billing business operations services.
- Managing and providing technology integration, development, and maintenance activities to support agreement operations;
- Providing 24x7 operations and maintenance and support for the bidder technology and health connector transactions processed in the systems
- Providing the health connector and its vendors with information necessary to provide appropriate coordination and scheduling of testing and system enhancements;
- Acting as a proactive, collaborative, and resourceful partner to the health connector, through recommending best practices and learnings from other clients, and facilitating consistent communication;
- provide samples of the following reports:
• System uptime and usage report;
• Enrollment and financial reconciliation report;
• Summary transaction report;
• Member Correspondence report;
• Delinquency report;
• Payment activity report;
• Comprehensive software release testing report
• Daily Enrollment and notice processing reports by type
- Communications
• Generate initial quotes for prospective employers, and brokers operating on their behalf
• Generate monthly invoices for enrolled groups
• Generate enrollment and billing notices for enrolled groups
• Send text and email, based on user preference, related to payment transactions and ad-hoc (outbound)
- Enrollment
• Process reinstatements and other retro-active enrollment changes
• Process mid-year changes as a result of a Qualified Life Event (QLE)
• General renewals, including plan mapping and noticing
• Identify and resolve discrepancies between Contractor and Carrier systems
- Billing and Payments
• Manage payments, delinquency and NPP for enrolled groups
• Online payment processing (ACH, Credit, Debit) for new and existing employers
• Lockbox payment processing for new and existing employers
• Process refund requests
- Brokers
• Process and distribute Broker commissions
• Issue Annual Broker 1099-NEC Tax forms
- Integrations & Access
• Integrate with Enroll App
• Integrate with third-party Notice Vendor
• Interface with carriers re: EDI (834, & 820, TA1 &999)    
• Provide agents, employers and brokers with online access to enrollment and billing system
- Other
• Support agency and Carrier audit requests
- Systems
- To assist employers, employees and brokers, the contact center vendor must establish secure connectivity to the following systems which are owned and maintained by our partners from the DC Health Benefit Exchange:
• Enroll App – eligibility and enrollment system
• Red mine – Incident management ticketing system
• Salesforce – Customer Relationship Management (CRM)
• Slack – Instant messaging system
• National Financial Partners (NFP) – Billing system
• Glue – EDI transmission system
• SharePoint – used to document sharing and collaboration between entities
• Box – used to share secure files, such as discrepancies, with carriers

- Contract Period/Term: 4 years