NIGP 94977: Self Insured Program, Prescription Drug

NIGP 94977 Self Insured Program, Prescription Drug (Item) encompasses pharmacy benefit management services and prescription drug plan administration for self-funded employee health plans across state and local public bodies, including school districts, counties, municipalities, and special-purpose health districts. State and local governments soliciting under this code are procuring full-service PBM claims administration, formulary management, utilization review, rebate processing, specialty pharmacy services, and transparent cost pass-through pricing models to support their self-insured prescription drug programs. Recent solicitations show demand for traditional bundled PBM services paired with medical plan administration, alternative and emerging pharmacy models such as voluntary international mail-order importation programs, and integrated administrative arrangements with medical TPA services that allow vendors to bid on pharmacy alone, medical alone, or fully integrated solutions.

Issuing bodies span large urban and suburban school districts (Northside Independent School District in San Antonio, Austin ISD), county health authorities (Travis County Healthcare District/Central Health, Suffolk County), municipalities (City of Temple, City of Edinburg), and regional health districts. School districts and county health authorities appear as repeat buyers in the recent-opportunity block. Geographic activity concentrates in Texas (with six of eight opportunities) and includes New York (Suffolk County, two proposals issued January 2026). Representative recent solicitations include Northside ISD RFP 2026-076 for Medical TPA and Pharmacy Benefit Management Services due May 6, 2026, covering approximately 18,000 covered members with a three-year contract term and optional two-year renewal; Travis County Healthcare District RFP 2605-004 for comprehensive medical ASO, prescription drug benefits, dental, and vision insurance due June 11, 2026, with current medical claims experience showing $4.68 million in catastrophic claims across approximately 2,000 covered lives; and Suffolk County RFP 2026-04 for PBM services to the self-insured Employee Medical Health Plan serving approximately 34,000 covered lives, with proposals due March 12, 2026, structured on per-member-per-month administration fees and per-prescription dispensing fees with 100% pass-through of manufacturer rebates and transparent component-level pricing.