Announcement of Contract Award to Accenture LLC for the California Healthcare Eligibility, Enrollment & Retention System (CalHEERS)

The California Health Benefit Exchange (the Exchange), in collaboration with the Department of Health Care Services (DHCS) and the Managed Risk Medical Insurance Board (MRMIB), has awarded a contract to Accenture LLC to develop a new consumer friendly web portal and eligibility and enrollment system to simplify and streamline how millions of individuals, families and small businesses in California can get affordable health coverage.

This contract is part of the Exchange’s implementation of the Affordable Care Act in California by designing and building a new web-based California Healthcare Eligibility, Enrollment and Retention System (“CalHEERS”). The CalHEERS system will be designed to start enrolling Californians in the fall of 2013 for coverage that will begin in January 2014. It will be implemented out in two stages:

• Release 1 (Portal). The current plans are for CalHEERS to “go live” on July 1, 2013 as a web portal to provide initial ability for individuals and small employers to shop and compare health plans.
• Release 2 (Enrollment). On October 1, 2013, CalHEERS should add functions that will allow individuals to see if they are eligible for Medi-Cal, Healthy Families, or subsidized coverage in the Exchange. CalHEERS will also help these individuals choose the health plan and benefit design that is right for them. The system will also provide all the processes needed to support small businesses buying coverage and support the premium processing and management of financial data.

The contract includes about $183 million for the initial development and implementation of the system. These costs will primarily be paid by the federal government through funds available to implement the Affordable Care Act. Once the system is in place, the contract also includes about $176 million for the continued development and initial operating costs over about three and a half years (approximately $50 million per year).

By the end of 2016, it is expected that an estimated 4.4 million Californians will have benefited from using the new portal to enroll in Medi-Cal, Health Families and get subsidies and enroll in health plans offered through the new health care marketplace administered by the California Health Benefit Exchange.

For more information on the Exchange go to www.healthexchange.ca.gov.

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