Summary

This is a Solicitation List of Respondents document issued by the State of Nebraska Department of Administrative Services for RFP #122436 O5, which seeks a Pharmacy Benefit Manager to provide comprehensive administrative support services for the state's employee health care prescription drug benefit plans. The solicitation targets approximately 13,600 enrolled members, including active employees, pre-65 retirees, COBRA participants, and their dependents, with services encompassing claims adjudication, member enrollment, formulary management, clinical management, pharmacy network management, and member services. The proposal submission deadline was July 18, 2025, at 2:00 p.m. Central Time, with an anticipated contract award in October 2025. The initial contract term will extend through June 30, 2029, with options to renew for two additional one-year periods, with the benefit plan year commencing July 1, 2026.

Five responsive bids were received: Blue Cross and Blue Shield of Nebraska, Inc.; MedImpact Healthcare Systems, Inc.; OptumRx, Inc.; United HealthCare Services, Inc.; and Rightway Healthcare, Inc. One non-responsive bid was submitted by Ventegra Foundation. 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. Required qualifications include at least five years of self-funded group experience, licensure in all 50 states, and current service to a public sector group health plan with a minimum of 15,000 lives. The cost structure includes per member per month (PMPM) administrative fees with guaranteed pricing for pharmacy network services. Performance guarantees include potential financial penalties ranging from $2,000 to $50,000 per occurrence, with comprehensive HIPAA compliance requirements through a Business Associate Agreement.