4-RFP 2026-04 Appendix A.pdf

This is a Pre-Proposal Required Form Intent to Propose document issued by the SC Office of Central Procurement on behalf of Suffolk County, New York, for Pharmacy Benefit Management (PBM) Services for the Commercial Prescription Drug Program of the Self-Funded Employee Medical Health Plan (EMHP). The RFP, numbered 2026-04 with commodity codes 958-56 and 949-77, was issued on January 22, 2026. All potential proposers must complete and return the Intent to Propose Form via email to receive census and plan financial information necessary for proposal development. The form requires respondents to indicate either their intent to bid on the PBM Services or to decline participation with an explanation of reasons. Intent to Propose Forms must be received by 3:30 PM Eastern Time on February 2, 2026.

The form requires submission of agency name, authorized signature, printed name, telephone number, email address, and date of submission. No specific pricing information, set-asides, incumbent contractors, award dates, or contract term details are provided within this pre-proposal document itself. This form serves as a preliminary screening mechanism to identify qualified bidders and ensure they receive essential plan data and census information required to develop comprehensive and competitive proposals for the PBM services contract.