5-Additional Information on Current Coverage.xlsx

This file contains additional information on current coverage for the Provo City School District's Request for Proposal for Group Medical and/or Pharmacy Benefit Management services. The District, a school system with over 100 years of operation located in Utah, seeks to procure medical administration and pharmacy benefit services effective September 1, 2026. The RFP allows for three award options: combined medical and PBM services, medical administration only, or PBM services only. The initial contract term is three years beginning September 1, 2026, with options for extension of up to two additional one-year periods under the same terms and conditions, followed by potential year-to-year renewals for up to five additional years, all contingent on satisfactory performance and District determination that renewal is in its best interest.

The District currently operates under a self-funded model with 2,039 eligible employees, 824 enrolled employees, and an undisclosed number of covered retirees. Present medical coverage through UnitedHealthCare (UMR) has been in place for two years and includes three plan options: a $1,500 PPO, $1,500 Dual PPO, and $2,500 HDHP, with renewal rates ranging from $734.33 to $2,454.10 depending on coverage tier. The District requires networks through UMR/UHC with specific stop loss specifications, including an individual deductible of $200,000 and an aggregate corridor of 125% for medical and prescription drug coverage. The current arrangement includes a 12/18 contract structure with a six-month run-out period, and the RFP solicits responsive and responsible vendors with the highest evaluation score per procurement code requirements.