Pharmacy Benefit Management Services

The Vendor is required to provide of a pharmacy benefit manager (PBM) offering a comprehensive pharmacy benefit management solution.
- The County is currently under one PBM contract for all Active Employees and their dependents, as well as both Pre- and Post-65 Retirees and their dependents.
- The Client is specifically interested in how the PBM performs in the following areas:
•    Discount guarantees with per-unit price stability
•    Administrative fee structure
•    Maximizing generic utilization
•    Percentage of earned rebates to the client with minimum floor guaranteed rebates, without overutilization of brand drugs
•    Performance guarantees
•    Stable and decreasing PMPM (per member per month) spending trend
•    Stable formulary, focused on lowest net cost drugs
•    Drug monitoring and utilization review programs
•    Innovative programs, such as therapeutic mac, disease management, therapeutic interchange programs, limited network strategies, retail pharmacy partnerships, etc.
•    Periodic reviews – financial, clinical, market, strategic
•    Effective customer, client, and consultant communications and messaging.
•    Mail cost savings opportunities with incentives programs
•    Organizational stability and experience
•    Customer service representative and account manager capabilities.
•    Ability to work with the selected third-party claims administrators, data aggregators, consultant and other entities that may be involved with the administration of the health plan to provide up to daily electronic exchanges of eligibility, and claims information
•    Online member information resources, including mobile applications
•    Biosimilar net cost strategy including guarantees, utilization management and formulary placement.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: September 02, 2025