To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Contract #77-785 with MIS, Inc.
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to execute on behalf of the County Contract #77-785 with MIS, Inc. (dba in California as Mature Insurance Solutions), a corporation, in an amount not to exceed $6,000,000, to provide enrollment services for Medi-Cal and Medicare Advantage Programs administered by Contra Costa Health Plan (CCHP), for the period July 1, 2025 through June 30, 2027.
FISCAL IMPACT:
Approval of this Contract will result in contractual service expenditures of up to $6,000,000 over a two-year period and will be funded 100% by CCHP Enterprise Fund II revenues.
BACKGROUND:
CCHP will launch a Dual Eligible Special Needs Plan (D-SNP) on January 1, 2026 for people who qualify for both Medicare and Medi-Cal assistance. Enrollment in a D-SNP requires members to enroll with someone with the following licensure: California Accident & Health or Sickness license issued by the California Department of Insurance. Currently, Contra Costa County does not have an established job classification that meets these minimum licensure qualifications. While CCHP is working with Health Services Department’s Personnel Unit and County Human Resources to revise existing Minimum Qualifications, CCHP will not have county staff in place in time for the Fall 2026 Medicare Advantage open enrollment period. To ensure CCHP has a path to enrollment, CCHP needs to contract with brokerage agencies that can meet these requirements and help facilitate enrollment. If CCHP does not establish a mechanism for enrollment through licensed brokers, it faces the possibility of zero D-SNP enrollment, which poses a serious financial and operational risk. This contract has been reviewed and approved by the Health Services Department’s Personnel Unit to ensure no labor conflicts.
Per Administrative Bulletin 600.3 the Department has posted a continuous Request for Qualifications and maintains a current qualified list of vendors at all times.
Approval of new Contract #77-785 will allow the Contractor to provide enrollment services for Medi-Cal and Medicare Advantage Programs administered by CCHP through June 30, 2027.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, CCHP would not be able enroll people who qualify for both Medicare and Medi-Cal into the it’s D-SNP Program which would cause serious financial and operational risks.