This contract awards Milliman, Inc. the provision of actuarial consulting services to support Covered California’s health‑ and dental‑insurance marketplace. The work includes rate development, risk‑adjustment analysis, benefit‑plan design, compliance with ACA actuarial‑value requirements, and ongoing actuarial support for Qualified Health Plans covering plan years 2026‑2029. The contract is a three‑year, fixed‑price agreement with a maximum ceiling of $1.5 million, subject to annual budget approval and possible extensions of up to two additional years. Key elements include:
• Development and review of premium rates for individual and small‑group markets using CMS Uniform Rate Review Template and Federal Actuarial Value Calculator.
• Simulated risk‑adjustment modeling and advisory services for premium‑stabilization programs (reinsurance, risk adjustment, risk corridors).
• Delivery of actionable actuarial findings to Covered California staff and coordination with state regulators and other vendors.