122436 O5 - PBM Evaluation Criteria.docx
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- Solicitation number
- 122436 O5
- Issued by
- Blaine County, Nebraska
About this file
The file 122436 O5 - PBM Evaluation Criteria.docx is a Request for Proposal (RFP) issued by the State of Nebraska Department of Administrative Services for a Pharmacy Benefit Manager (PBM) to provide comprehensive administrative support services for the state's employee health care prescription drug benefit plans. The solicitation seeks a self-funded PBM administrator to serve approximately 13,600 enrolled members, including active employees, pre-65 retirees, COBRA participants, and their dependents. The RFP was released on June 9, 2025, with proposal responses due by July 18, 2025, at 2:00 p.m. Central Time, and an anticipated contract award in October 2025. The initial contract term will run through June 30, 2029, with options to renew for two additional one-year periods, and the benefit plan year commencing on July 1, 2026.
The cost structure includes per member per month (PMPM) administrative fees, with guaranteed pricing for pharmacy network services across retail, mail, and specialty medication channels. The estimated enrollment is consistently around 28,386 members throughout the contract period, with the state expecting transparent pricing, minimum AWP discounts for brand and generic medications, and comprehensive rebate guarantees. The selected vendor must have at least five years of self-funded group experience, be licensed in all 50 states, and currently serve a public sector group health plan with a minimum of 15,000 lives. Evaluation criteria include 25 points for Corporate Overview, 55 points for Technical Response, and 20 points for Cost, with potential additional points for vendor demonstrations. The RFP requires a comprehensive Business Associate Agreement to ensure HIPAA compliance and includes detailed performance guarantees with potential financial penalties ranging from $2,000 to $50,000 per occurrence, emphasizing the state's commitment to a rigorous and performance-driven procurement process.
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Text version
SOLICITATION EVALUATION CRITERIA
SOLICITATION NUMBER: 122436 O5
Administrative Support Services for the State of Nebraska Employee Health Care Prescription Drug Benefit Plans Opening Date: July 18, 2025
Mandatory Requirements The solicitation responses will first be examined to determine if all mandatory requirements listed below have been addressed to warrant further evaluation. Responses not meeting mandatory requirements will be excluded from further evaluation. The mandatory requirement items are as follows:
Contractual Agreement Form signed manually in ink or by DocuSign.
Corporate Overview;
Completed Sections II through IV;
Completed Technical Response, including, but not limited to;
Completed Attachment C – Confirmations & Questionnaire;
Completed Formulary Disruption Analysis as requested in Questionnaire Tab D.3;
Completed Network Disruption Analysis as requested in Questionnaire Tab F.14;
Completed Attachment A - Intent to Propose Form;
Completed Attachment B - Business Associate Agreement;
Completed Attachment D - Performance Guarantee Sheet; and Completed Cost Sheet.
Evaluation Criteria All responses to this solicitation, which fulfill all mandatory requirements, will be evaluated. Each category will have a maximum possible point potential. Areas that will be addressed and scored during the evaluation include:
| Evaluation Criteria |
| Possible Points |
| Part 1 Corporate Overview |
| 25 |
| Part 2 Technical Response |
| 55 |
| Part 3 Cost |
| 20 |
| Total Points without Vendor Demonstrations |
| 100 |
| Vendor Demonstrations, (if required) |
| 20 |
| Total Points with Vendor Demonstrations |
| 120 |
Part 3 – Cost Cost points should be calculated as follows, accounting for cost realism and reasonableness:
0. Establish lowest realistic cost submitted – lowest cost submitted receives the maximum points.
0. To assign points to all others, the following formula should be followed:
Lowest Cost Submitted Cost Submitted x Maximum Possible Cost Points = Cost Points to Award (see samples below)
Formula
Sample
Sample
Sample
Lowest Cost Submitted
$100,000
$100,000
$100,000
Cost Submitted
$100,000
$200,000
$150,000 x Maximum Possible Cost Points
= Points To Award
20.00
10.00
13.33
122436 O5 Evaluation Criteria
File details come from the government source that posted it. Updated .