Self-Funded Plan, Carrier and Third Party Administrator, Preferred Provider Organization, Network, Pharmacy Benefit Management Services

The Vendor is required to provide for Self-Funded Plan, Carrier/Third Party Administrator (TPA), Preferred Provider Organization (PPO) Network, Pharmacy Benefit Management (PBM) Services, Transparent Modeling and or Pass-Through Modeling, International Rx Option and Stop Loss Coverage. For the purpose of this RFP, the Edinburg Employee Benefit plan is considered “Grandfathered” under Affordable Care Act (ACA).
-Prime Therapeutics currently provides Pharmacy Benefit Management (PBM) Services. Blue Cross Blue Shield is the current Stop Loss Carrier with a current coverage of $350,000 as the specific deductible and with a $165,000 aggregate deductible.