COUNTY OF ALAMEDA

REQUEST FOR PROPOSAL No. 902795 for

PHARMACY BENEFIT MANAGEMENT SERVICES

For complete information regarding this project, see Request for Proposal (RFP) posted at County of Alameda Procurement Portal [https://procurement.opengov.com/portal/acgov] or contact the County Thank you for your interest!

Contact Person: A. Ramesh Phone Number: (510) 208-3905 Email Address: a.ramesh@acgov.org General Services Agency (GSA) – Procurement

RESPONSE DUE

by 2:00 p.m.

on November 4, 2026 through Alameda County, GSA-Procurement County of Alameda Procurement Portal https://procurement.opengov.com/portal/acgov

CALENDAR OF EVENTS

PHARMACY BENEFIT MANAGEMENT SERVICES

TO ATTEND ONLINE:

Join: 902795 PBM Bidder Conference Meeting ID: 230 989 343 923 820 Passcode: 2qQ3BT3Z Dial in by phone +1 415-915-3950,,983540105# United States, San Francisco

(888) 715-8170,,983540105# United States (Toll-free) Find a local number Phone conference ID: 983 540 105# Join on a video conferencing device Tenant key: alamedacountyca@m.webex.com Video ID: 117 117 945 7 For organizers: Meeting options | Reset dial-in PIN

Written Questions Due via the “Question & Answer” tab of this project in the County of Alameda Procurement Portal October 9, 2026, by 5:00 p.m.

Response Due and Submitted through County of Alameda Procurement Portal

November 4, 2026, by 2:00 p.m.

Followed immediately by online Public Bid Opening which can be joined here:

Join: 902795 PBM Bid Opening Meeting ID: 241 752 822 128 551 Passcode: jz7pk2Ux Dial in by phone +1 415-915-3950,,235191175# United States, San Francisco

(888) 715-8170,,235191175# United States (Toll-free) Find a local number Phone conference ID: 235 191 175# Join on a video conferencing device Tenant key: alamedacountyca@m.webex.com Video ID: 118 002 415 1 More info For organizers: Meeting options | Reset dial-in PIN

NOTE: All dates are tentative and subject to change.

Alameda County Vendor Outreach Wednesday, October 7, 2026 10:30 a.m. – 11:30 a.m.

TO ATTEND ONLINE:

Vendor Outreach Call-in: +1 415-915-3950 Conference ID: 504 517 635#

COME MEET ALAMEDA COUNTY’S

PROCUREMENT TEAM!

This public event is not specific to any RFP, where vendors can speak with GSA professionals, get to know them, and learn more about contracting opportunities with the County.

These are conducted on most Wednesdays. Dates and locations can be confirmed by checking at Upcoming Events [https://gsa.acgov.org/do-business-with-us/upcoming-contracting-events/]

SPECIFICATIONS, TERMS & CONDITIONS

for

PHARMACY BENEFIT MANAGEMENT SERVICES

TABLE OF CONTENTS

Page

ATTACHMENTS

STATEMENT OF WORK

INTENT

It is the intent of these specifications, terms, and conditions to describe Pharmacy Benefit Management (PBM) being requested by the Alameda County Behavioral Health Department (ACBHD).

The County intends to award a three-year contract (with the option to renew for two years) to the Bidder selected as the most responsive and responsible Bidders whose response conforms to the RFP and meets the County’s requirements.

SCOPE/BACKGROUND

Alameda County Behavioral Health Care Department is the county-operated provider serving approximately 50,000 patients annually with serious and persistent mental illness through its system of care. ACBHD administers this care through a combination of county-operated community support centers, and contracts with private community-based organizations.

Currently, there is a network of approximately 45 psychiatrists serving uninsured, MediCal and MediCare patients (adults, youths and children) at nearly 40 programs as well as at certain day treatment and transitional age youth programs. Additionally, under the Affordable Care Act, ACBHD has added 15 programs under its Low Income Health Plan (LIHP) called the Health Program of Alameda County (HealthPAC) Behavioral Health Care Specialty Service, expanding its coverage of uninsured patients requiring mental health treatment.

ACBHD is the payer of last resort when it is determined that the patient being served does not qualify for programs sponsored by government agencies such as MediCal & MediCare.

The Contractor will administer coverage for all prescriptions written for uninsured and HealthPAC Behavioral Health Care Specialty Service patients seen by the network prescribers of ACBHD. In addition, Contractor will provide these services for Medi-Cal clients with a denied medication Prior Authorization Request (PA) or Share of Cost (SOC), Medicare Part D clients whose medication is non-formulary or a denied appeal, and Medicare Part D clients’ medication co-pays. The Contractor will also administer ACBHD use of drug companies’ Patient Assistance Programs (PAP) and the Federal 340B drug purchasing program.

During the 2024-2025 fiscal year, ACBHD provided a total of approximately 1,600 prescriptions for 650 uninsured patients, filled through 45 retail pharmacies, with no mail prescriptions filled. Pharmaceuticals costs were estimated to be $135,000.

BIDDER QUALIFICATIONS

BIDDER Minimum Qualifications Bidder and all key personnel assigned to the project must be regularly and continuously engaged in the business of providing PBM services to agencies similar to ACBHD (public and/or government agencies) for at least five (5) years, which must be clearly stated or demonstrated in the bid response.

Bidder must possess all permits, licenses, and professional credentials necessary to supply products and perform services specified under this RFP. Unless noted otherwise in the RFP, for example the item(s) stated above, including any Addendum, Bidder is not required to submit copies or verification of the permits, licenses and credentials; however, Bidder must provide such proof if requested by County.

SPECIFIC REQUIREMENTS

Contractor must have the ability to provide services as follows:

Contractor shall provide a reliable, transparent, and fully accountable pharmacy benefit management program that ensures eligible ACBHD patients have timely access to clinically appropriate medications; claims, eligibility, coordination-of-benefits, 340B transactions, and pharmacy payments are processed accurately; all contractual discounts, rebates, credits, and savings are properly captured and passed through to the County; County data and PHI are protected and readily auditable; and services continuously meet established access, financial, operational, reporting, and performance standards.

Transparency and Full Pass-Through Pricing. Contractor shall administer the County’s pharmacy benefit using a fully transparent pass-through pricing model. Except for compensation expressly identified in the Agreement and County-Approved Bid Form, Contractor shall not retain any spread, differential, rebate, discount, administrative fee, service fee, pharmacy network fee, manufacturer payment, or other remuneration attributable to prescriptions or services provided under this Agreement.

Contractor shall pass through to the County one hundred percent (100%) of all amounts required by the Contract to be passed through, including applicable pharmacy discounts, credits, recoveries, refunds, and the County's contractual share of manufacturer rebates and other remuneration.

Contractor shall maintain transaction-level documentation sufficient for the County or its authorized auditor to independently reconcile amounts billed to the County, amounts paid to pharmacies, Contractor compensation, rebates and other amounts received or retained in connection with the County's claims.

Compensation—Per-Paid-Claim Adjudication Fee: The Contractor shall bill the County the applicable adjudication fee quoted for each contract year in the Bid Form. The fee shall not exceed $17.00 per paid claim. The Contractor must not charge an adjudication fee for rejected or reversed claims.

Claims Adjudication: Provide online, point of service, electronic claims adjudication for prescriptions 24 hours daily, 7 days per week.

Claims Adjudication Accuracy. Contractor shall adjudicate not less than 99.5% of eligible claims accurately, based on the County-approved eligibility rules, formulary, benefit configuration, coordination-of-benefits requirements, pricing terms, pharmacy network terms, and other Contract requirements. Contractor shall promptly correct erroneous adjudications and reimburse or credit the County for verified overpayments resulting from Contractor error.

Financial Accuracy. Contractor shall maintain not less than 99.5% financial accuracy for claims billed to the County, measured through County-approved claims audits or reconciliation.

Contractor's production claims adjudication system shall maintain at least 99.9% monthly availability, excluding County-approved scheduled maintenance. Scheduled maintenance shall be conducted during off-peak periods and Contractor shall provide the County advance notice of planned outages. Contractor shall immediately notify the County of any unplanned outage materially affecting pharmacy claims processing and provide status updates through restoration.

Consumer Access and Services: Provide a network of geographically and culturally diverse pharmacies specific to meet the needs of Alameda County residents, this shall include:

Contractor shall maintain a pharmacy network sufficient to provide reasonable and timely access to covered medications throughout Alameda County. Contractor shall monitor network adequacy throughout the Contract term and notify the County within five (5) business days of any network change that materially affects access. Pharmacies that are language-capable in the network must include:

Cambodian, Chinese, Farsi, Japanese, Spanish, and Vietnamese.

Extended hour pharmacy coverage.

Weekend coverage.

Delivery services.

Blister-packing/specialty packing.

At least one network pharmacy in each city and populated unincorporated area of Alameda County.

Contractor shall provide, upon request, a current network-access report identifying pharmacy location, operating hours, weekend availability, delivery availability, specialty/blister-pack capability, and available language services.

Eligibility Administration. Contractor shall process County-authorized eligibility additions, changes, and terminations at least daily and ensure that successfully transmitted eligibility updates are reflected in the claims adjudication system no later than the next scheduled processing cycle. Contractor shall provide automated confirmation identifying records accepted, rejected, or requiring correction and shall resolve Contractor-caused processing errors within one (1) business day. Groups to be populated presently include, but are not limited to:

Uninsured adults, children or transitional age youth (TAY), including clients with an unmet Medi-Cal share of cost (Level I);

HealthPAC Behavioral Health Care (Levels II & III);

Medically Indigent Adult (MIA) Medication Program using Patient Assistance Programs (PAPs);

Medicare Part D Coordination of Benefit (COB); and Urgent uninsured children or TAY for specific day programs.

340B Third Party Administration. Contractor shall administer the County's 340B program in a manner that maintains accurate patient, prescriber, covered-entity, pharmacy, and drug eligibility; accurately identifies eligible 340B transactions; supports timely replenishment and virtual inventory reconciliation; and prevents diversion and duplicate discounts.

Contractor shall maintain transaction-level audit trails sufficient to trace each 340B-qualified prescription from claim adjudication through accumulation, replenishment, pharmacy settlement, and final reconciliation.

Contractor shall identify and correct transaction discrepancies within ___ business days after identification and shall provide the County with periodic reconciliation reports identifying qualified claims, excluded claims, reversals, replenishments, unresolved exceptions, duplicate-discount controls, and financial results.

Contractor shall promptly notify the County of any material 340B compliance issue and cooperate with County-directed corrective action and audits.

Electronic Health Record (EHR) Interface. Contractor shall design, configure, test, implement, and maintain interfaces required to exchange County-authorized PBM information with ACBHD's EHR system. Contractor shall be responsible for all Contractor-side licenses, subscriptions, interfaces, development, configuration, testing, maintenance, and other costs necessary to provide the required interface, at no additional cost to the County.

Before production deployment, Contractor shall successfully complete County-approved interface testing demonstrating accurate transmission, receipt, validation, error handling, reconciliation, security, and recovery of required transactions. Production implementation shall not occur until written County acceptance.

Eligibility Requirements: The ability to administer the ACBHD’ eligibility requirements, including, but not limited to verification that:

Each patient is a County-authorized patient;

Each prescriber is a County-authorized prescriber;

Each medication is on at least one of the ACBHD formularies;

If a medication is available as a generic, that it is dispensed as a generic medication, even if it is prescribed as a brand-named medication; and Approval of medication prior authorization (PA), and the procedure for placing a PA.

Program Design: Maintain the following on an on-going basis as directed by ACBHD:

Specific eligibility groups as defined by ACBHD;

ACBHD formularies and prescribing guidelines/requirements;

Network of prescribers;

Network of Pharmacies; and Eligibility upload (see #6).

Prescription Claims Data: Prescription claims data transmission on a monthly basis, not to exceed 12 times per fiscal year; and, no more than three (3) business days after the close of the month.

Monthly Billing: Invoicing to ACBHD for payment on a monthly cycle, not to exceed 12 times per fiscal year.

Claim Reversals and Recoveries. Upon receipt of a valid County reversal request, Contractor shall initiate the reversal or recovery within five (5) business days and provide confirmation identifying the affected claim, original County charge, amount reversed or recovered, disposition date, and corresponding invoice credit. Contractor shall include all completed and outstanding reversals in the next monthly reconciliation report.

Paper or Manual Claims. Contractor shall adjudicate complete and eligible paper/manual claims within thirty (30) calendar days after receipt and shall apply the same eligibility, benefit, pricing, coordination-of-benefits, accuracy, and audit requirements applicable to electronically adjudicated claims.

Government Healthcare Program Experience. The Bidder must have at least two (2) years of experience providing services to, or working with, a governmental healthcare program. The required experience must be clearly demonstrated in the Bidder’s response. Experience involving governmental mental health programs is preferred and may receive additional consideration during the evaluation.

Account management & customer service: Provide responsive account management and customer services to the County and pharmacies. This shall include, but not be limited to, meeting the following requirements:

Contractor shall acknowledge routine County inquiries within one (1) business day and provide resolution or a documented resolution plan within three (3) business days unless otherwise agreed by the County. Critical issues affecting member access, claims processing, data security, or County operations shall be acknowledged within one (1) hour and actively managed through resolution.

Provide ACBHD a dedicated account coordinator with at least two (2) years of experience who will be responsible for the overall Contract requirements, terms and problem resolution. This person must:

Be available Monday through Friday from 8:30 a.m. – 5:00 p.m. (Pacific Time).

Provide a cell phone or pager number for emergencies/disaster support, with response time within one (1) hour.

Meet with the County Pharmacy Director (Director) or designee as requested and needed, either in person, by telephone, or via videoconference.

Maintain, during off hours, a toll-free voice mail recording system, with all messages answered within the next business day.

For ACBHD network pharmacies:

Provide Toll-free telephone lines for customer service (Help Line), availability Monday through Friday from 8:30 a.m. – 6:00 p.m. Pacific Time, with additional hours over the weekend.

Conduct periodic, at minimum annual, retail pharmacy surveys. Consult with the Director on survey criteria prior to conducting survey.

Medi-Cal-covered Patients: Ensure network pharmacies coordinate benefits (COB) for patients covered through Medi-Cal with:

Medi-Cal SOC.

Medication PA submission, including:

Non-covered Medi-Cal medications.

MediCare Part D-covered Patients: Ensure network pharmacies coordinate benefits (COB) for patients covered through MediCare Part D, and for formulary-covered medications, ensuring that payment from the County only occurs for:

Medication co-pays;

Medication cost-sharing; and Denied medication appeals.

Rebates and Manufacturer Remuneration. Contractor shall identify, account for, and report all rebates and other manufacturer remuneration attributable to eligible County prescription claims. The County shall receive not less than ninety percent (90%) of all such amounts attributable to the County, unless a more favorable percentage is proposed by Contractor and incorporated into the Agreement.

For purposes of this requirement, rebate-related remuneration includes rebates, supplemental rebates, administrative or service fees attributable to County utilization, market-share payments, formulary payments, price-protection payments, inflation payments, credits, and other manufacturer-funded remuneration attributable to County claims, to the extent applicable under Contractor's arrangements.

Contractor shall remit amounts due to the County quarterly and provide sufficient claim-level or aggregate supporting documentation, subject to applicable confidentiality restrictions, for the County to reconcile the calculation. Amounts shall be paid within six (6) calendar days following Contractor's receipt of the applicable manufacturer payment and in no event later than the contractual reconciliation deadline established by the County.

Training: Provide virtual training to County staff and other users identified by the Director for its web-based ad hoc user query system at no cost to the County and to its users.

Performance Guarantees. Contractor shall meet the performance guarantees established below beginning on the Contract start date. Performance shall be measured and reported monthly and evaluated quarterly. Failure to meet a performance guarantee shall result in the applicable service credit or liquidated performance amount, without limiting other contractual remedies available to the County.

Business Associates Agreements/HIPAA Compliance: Contractor must be HIPAA compliant, including taking all actions necessary to be compliant with business associates requirements.

Audit and Financial Transparency. Contractor shall maintain complete and accurate books, records, claims data, pharmacy payment records, rebate records, pricing records, eligibility records, 340B transaction records, and other documentation necessary to verify Contractor's compliance with the Agreement.

Upon reasonable notice, the County or its authorized independent auditor shall have the right to audit Contractor's performance and financial compliance, including claims adjudication, pharmacy payments, discounts, dispensing fees, rebates, administrative fees, 340B transactions, duplicate discounts, eligibility determinations, pricing guarantees, performance guarantees, and other amounts paid, received, retained, credited, or passed through in connection with the Agreement.

Contractor shall provide records in a reasonably usable electronic format and shall cooperate with County audits without imposing additional access, programming, retrieval, or administrative charges. Any verified overpayment or amount due to the County shall be refunded or credited within thirty (30) calendar days after final determination.

Contract Transition and Exit Assistance. Upon expiration, termination, or County request in anticipation of transition, Contractor shall cooperate with the County and any successor contractor to ensure uninterrupted pharmacy benefit services. Contractor shall timely provide County-owned eligibility, claims, formulary, pharmacy network, 340B, rebate, audit, configuration, reporting, and other County data in a mutually agreed, commercially reasonable electronic format.

Contractor shall not withhold County data because of a contractual dispute and shall provide reasonable transition assistance through completion of the County-approved transition period.

County Data Ownership and Use. All eligibility, claims, utilization, financial, rebate, 340B, prescriber, pharmacy, reporting, and other data created for or attributable to the County's program shall remain the County's data. Contractor shall use County data solely as necessary to perform the Contract and as otherwise expressly authorized in writing by the County, subject to applicable law and the HIPAA Business Associate Agreement.

DELIVERABLES / REPORTS

Contractor must provide an ad hoc web-based query tool that is user-friendly for reviewing prescription claims data, including National Council for Prescription Drug Programs (NCPDP) fields and be able to generating reports 24 hours after claim adjudication. The query tool must be available 24 hours daily, 7 days per week, and be able to download reports into Excel.

Contractor must use basic programmed reports, downloadable in Excel that can be generated in query tool within a user-identified period. Programmable reports shall include those defined by:

Medication name (including all medications);

Prescriber DEA Number (including all prescribers);

Patient identifier (including all patients); and By specific account.

Deliverables Matrix

Contractor must provide online/virtual training and have educational and technical support, as directed by the County and will be available at no cost, including when there is a change in staff, specific to the use of the web-based query tool.

Invoicing. Each monthly invoice shall be accompanied by transaction-level supporting data sufficient for the County to reconcile the invoice to adjudicated claims. At minimum, supporting documentation shall identify claim/reference number, service date, paid date, pharmacy, drug/NDC or other County-approved drug identifier, quantity, ingredient cost, dispensing fee, applicable discount, amount paid to pharmacy, amount billed to County, Contractor administrative/adjudication fee, reversal or adjustment amounts, and other County-approved reconciliation fields.

Contractor shall separately identify PBM administrative fees, 340B fees, paper claim fees, programming/reporting fees, credits, recoveries, reversals, and other charges. No fee not expressly identified in the Agreement/Bid Form shall be payable by the County.

Implementation and Transition Plan. Within ten (10) business days after Contract execution, Contractor shall submit a detailed implementation plan for County approval. The plan shall identify tasks, milestones, dependencies, responsible parties, testing activities, data conversion, eligibility configuration, formulary configuration, pharmacy network readiness, 340B configuration, EHR/interface activities, training, communications, contingency procedures, and production-readiness criteria necessary to achieve full operational readiness by the Contract start date.

Contractor shall maintain and update the plan throughout implementation and immediately identify any condition that may jeopardize a milestone or the production start date, together with corrective action and recovery schedule.

Bidder is to submit an implementation and transition plan in the Exhibit A – Bid Response Packet, Implementation and Transition Plan.

BIDDERS CONFERENCE(S)/VENDOR OUTREACH

The Bidders Conference(s) held on the date(s) specified in the Calendar of Events will have online conference capabilities for remote participation. Bidders can opt to participate via a computer with a stable internet connection (the recommended Bandwidth is 512Kbps) at:

Join: 902795 PBM Bidder Conference Meeting ID: 230 989 343 923 820 Passcode: 2qQ3BT3Z Dial in by phone +1 415-915-3950,,983540105# United States, San Francisco

(888) 715-8170,,983540105# United States (Toll-free) Find a local number Phone conference ID: 983 540 105# Join on a video conferencing device Tenant key: alamedacountyca@m.webex.com Video ID: 117 117 945 7 For organizers: Meeting options | Reset dial-in PIN

1. Vendor Outreach is usually conducted on Wednesdays at Vendor Outreach Link (Call-in: +1 415-915-3950; Conference ID: 504 517 635#). Dates and locations can be confirmed by checking at: Upcoming Events [https://gsa.acgov.org/do-business-with-us/upcoming-contracting-events/].

Information regarding the RFP will be presented during the conference(s). To get the best experience, the County recommends that Bidders who participate remotely use equipment with audio output such as speakers, headsets, or a telephone.

2. Bidders Conference(s) will be held to:

Provide an opportunity for Small Local Emerging Businesses (SLEBs) and large firms to network and develop subcontracting relationships to participate in the contract(s) that may result from this RFP.

Provide an opportunity for Bidders to request clarification on this RFP and ask specific questions about the project, goods, and services.

Provide the County with an opportunity to receive feedback related to this RFP.

The Bidders Conference(s) Attendees List will be released in a separate document.

Written questions submitted by the stated deadline will be addressed in a posted RFP Questions and Answers (Q&A) following the Bidders Conference(s). Should there be a need to amend or revise the RFP, an Addendum will be issued. Any verbal statements, including at any Bidders Conference(s) are not binding. Only the written documents will be binding.

Questions regarding these specifications, terms, and conditions are to be submitted in writing through the “Question & Answer” tab of this project in the County of Alameda Procurement Portal by 5:00 p.m. on the date specified in the Calendar of Events.

Attendance at the Bidders Conference(s) and Vendor Outreach are highly recommended but are not mandatory. Vendors who attend the Bidders Conference(s) will be added to the Vendor Bid List.

COUNTY PROCEDURES, TERMS, AND CONDITIONS

EVALUATION CRITERIA / SELECTION COMMITTEE

1. Initial Evaluation (Completeness of Response and Debarment and Suspension). All proposals will first be reviewed to determine if they pass the initial Evaluation Criteria (Section A), which are determined on a pass/fail basis.

2. Evaluation by County Selection Committee. All proposals that have passed the initial Evaluation Criteria will be evaluated by a County Selection Committee (CSC). The CSC may be composed of County staff and other parties that may have expertise or experience related to the goods or services that are being procured. The CSC will score the proposals according to the Evaluation Criteria set forth in this RFP. Other than the initial pass/fail Evaluation Criteria, the evaluation of the proposals will be within the sole judgment and discretion of the CSC.

3. Unrealistic Bids. Bidders should bear in mind that any proposal that is unrealistic in terms of the technical or schedule commitments or unrealistically high or low in cost may be deemed reflective of an inherent lack of technical knowledge or indicative of a failure to comprehend the complexity and risk of the County’s requirements as set forth in this RFP.

4. Price Discrepancy. In the case of a discrepancy between the unit price and an extension, the unit price will be used for evaluation purposes.

5. Evaluation Criteria Descriptions. The items listed in the Evaluation Criteria should be considered as minimum requirements. All information contained in a proposal and presented in vendor interviews (if there are interviews) will be considered during the evaluation process and included in scoring within the appropriate Evaluation Criteria.

6. Evaluation Scores. Proposals will be evaluated and scored on the zero to five-point scale within each Evaluation Criteria below. Scores for all Evaluation Criteria (see the section below) will then be added, according to their assigned weight (below), to arrive at a weighted score for each proposal. A proposal with a higher-weighted total will be deemed of higher quality than a proposal with a lesser-weighted total.

7. Shortlist Process. The evaluation process may include a two-stage approach including a preliminary evaluation of the written proposal and preliminary scoring to develop a shortlist of Bidders that will continue to the final stage of optional vendor interview, and reference checks. The preliminary scoring will be based on the total points, excluding any points allocated to references, and optional vendor interview. The Five Bidders receiving the highest preliminary scores may advance to the next evaluation phase. All other Bidders will be deemed eliminated from the process. All Bidders will be notified of the shortlist participants; however, the preliminary scores at that time will not be communicated to Bidders.

8. Reference Checks. The County reserves the right to conduct reference check(s) on all Bidders who submitted a bid proposal. The CSC will then score the reference check(s), as identified in the Evaluation Criteria below, which will then be included in the final score.

9. Optional Vendor Interviews. The County may in its sole discretion, conduct vendor interviews. Should the County opt to conduct a vendor interview, the interview may include responding to standard and specific questions from the CSC regarding the Bidders’ proposal. Whether or not a shortlist process is used, the score of any evaluation criterion below may be revised or informed based on the vendor interview.

10. Final Score. The final maximum score for any procurement is 550 points, including the possible 50 points for local and small, local and emerging, or local preference points (maximum 10% of the final score; derived from 5% for local preference and 5% for either Small and Local or Emerging and Local preference). Proposals will be ranked by their final scores.

a. Without Vendor Interview. In procurements where there are no vendor interviews, the score received by the evaluation of the written proposal with the references score added will be the final score.

b. With Vendor Interview. In procurements where there are vendor interviews, the CSC will consider the interview and may adjust the scores received by the evaluation of the written proposal which, with the reference scores added, will be the final score.

11. Contact During Evaluation Process. All contact during the evaluation phase must be through the GSA-Procurement department only. Bidders must neither contact nor lobby CSC during the evaluation process. Attempts by Bidders to contact and/or influence members of the CSC may result in disqualification of Bidders.

12. Determining Award. As a result of this RFP, the County intends to award a contract to the highest-ranked responsible Bidder(s), as determined by the combined weight of the Evaluation Criteria, whose response conforms to the RFP and whose bid presents the greatest value to the County considering all Evaluation Criteria. The combined weight of the Evaluation Criteria is greater in importance than the cost in determining the best value to the County. The County may award a contract of higher qualitative competence over the lowest priced response.

13. The zero to five-point scale range is defined as follows:

14. The Evaluation Criteria and their respective weights are as follows:

Responses to this RFP must be complete. Responses must address all the requirements identified within this RFP and all related documents, including any Addenda. Failure to meet the Bidder Minimum Qualifications may also be considered an incomplete response and may result in the disqualification of the Bidder.

Pass/Fail

Bidders, its principal, and named subcontractors are not identified on the list of Federally debarred, suspended, or other excluded parties located at www.sam.gov/SAM.

Pass/Fail

The points for Cost will be computed by dividing the amount of the lowest responsive and responsible bid received by each Bidder’s total proposed cost.

Cost evaluation points may be adjusted by considering:

1. Reasonableness (i.e., how well does the proposed pricing accurately reflect the Bidder’s effort to meet requirements and objectives?).

2. Realism (i.e., is the proposed cost appropriate to the nature of the products and/or services to be provided? Is the price affordable to the County, including if costs exceed any budget contained in the RFP? ).

15 Points

Proposals will be evaluated, including considering the RFP specifications and the questions below:

1. How well does the Bidder demonstrate a clear and comprehensive understanding of the County's PBM program, populations served, operational requirements, and desired outcomes?

2. How well does the Bidder demonstrate that its proposed claims adjudication, eligibility, formulary, prior authorization, reversal, and program administration processes will provide accurate, timely, and reliable PBM services?

3. How well does the Bidder demonstrate that its proposed pharmacy network will provide adequate geographic, language, operating-hour, delivery, and specialty-packing access for County patients?

4. How well does the Bidder demonstrate an effective and compliant approach to 340B administration, Medi-Cal and Medicare Part D coordination of benefits, and rebate administration?

5. How well does the Bidder demonstrate that its proposed technology, EHR interface, reporting, financial transparency, and performance controls will enable effective County oversight and contract administration?

25 Points

Proposals will be evaluated, including considering the RFP specifications and the questions below:

1. How well does Bidder demonstrate that its proposed account management structure, staffing, responsibilities, availability, and escalation procedures will provide effective and responsive support to the County?

1. How well does the Bidder demonstrate that its pharmacy customer-service operation will provide timely and effective support to network pharmacies and minimize disruptions to patient medication access?

1. How well does the Bidder demonstrate effective processes for claims-data transmission, monthly billing, reconciliation, reversals, and paper/manual claims that will support accurate and efficient County contract administration?

1. How well does the Bidder demonstrate that its training, reporting, technical support, and ongoing communication approach will enable County staff to effectively use and oversee the PBM program?

1. How well does the Bidder demonstrate that its performance management approach will identify, measure, report, escalate, and correct service deficiencies and consistently achieve the County's performance guarantees?

20 Points

Proposals will be evaluated, including considering the RFP specifications and the questions below:

1. How well does the Bidder demonstrate a comprehensive, realistic, and achievable implementation and transition plan capable of achieving full operational readiness by the County's required start date?

1. How well does the Bidder demonstrate an effective approach to configuring, converting, validating, and testing eligibility, formularies, pharmacy networks, claims rules, 340B requirements, and other PBM program components before go-live?

1. How well does Bidder demonstrate that its proposed technology and EHR-interface implementation and testing approach will result in accurate, secure, reliable, and operationally ready systems?

1. How well does the Bidder identify significant implementation and transition risks and demonstrate effective contingency and mitigation strategies to protect continuity of pharmacy services and patient medication access?

1. How well does the Bidder demonstrate an effective go-live, stabilization, and transition-management approach that will support the County and network pharmacies before, during, and immediately following implementation?

20 Points

Proposals will be evaluated, including considering the RFP specifications and the questions below:

1. How well does the Bidder demonstrate relevant and successful experience providing PBM services of comparable scope and complexity to public-sector or governmental healthcare organizations, including experience with mental health programs or populations, based on the duration and relevance of its experience, populations served, scope of services and responsibilities, and measurable outcomes achieved??

2. How well does the Bidder demonstrate relevant experience supporting governmental behavioral-health or similarly complex populations and addressing their pharmacy-access and benefit-administration needs?

3. How well does Bidder demonstrate successful experience performing the specialized PBM functions required by this RFP, including 340B administration, claims adjudication, COB, rebate administration, reporting, and system/interface integration?

4. How well does the Bidder demonstrate a record of successfully implementing and transitioning comparable PBM programs on schedule while maintaining continuity of pharmacy services?

5. How well do the qualifications and relevant experience of the proposed key personnel demonstrate the team's ability to successfully implement, administer, and support the County's PBM program?

15 Points

Bidders that pass the Initial Evaluation may be invited to participate in a vendor interview and live demonstration of their proposed Pharmacy Benefit Management Services. The interview may include standardized and bidder-specific questions from the CSC regarding the bidder’s proposal. Whether or not a shortlisting process is used, scores assigned to any of the evaluation criteria above may be informed by or revised based on the vendor interview and demonstration.

If invited to participate, the bidder must demonstrate its proposed web-based query tool. The Bidder must demonstrate the system’s functionality, including generating sample reports, to allow the CSC to evaluate the functionality, usability, and reporting capabilities of the proposed web-based query tool.

Vendor Interview may be used to revise / inform scores of criteria above

SMALL LOCAL EMERGING BUSINESS PREFERENCE

1. CONTRACT EVALUATION AND ASSESSMENT

During the initial 120-day period of any contract awarded, the County may review the proposal, the contract, any goods or services provided, and/or meet with the Contractor to identify any issues or potential problems.

The County reserves the right to determine, at its sole discretion, whether:

The Contractor has complied with all terms of this RFP and the contract; and Any problems or potential problems with the proposed goods and/or services were evidenced, which makes it unlikely (even with possible modifications) that such goods and/or services have met or will meet the County requirements.

If, as a result of such determination, the County concludes that it is not satisfied with the Contractor’s performance under any awarded contract and/or Contractor’s goods and services as contracted for therein, the Contractor may be notified that the contract is being terminated. The Contractor must be responsible for returning County facilities to their original state at no charge to the County. The County will have the right to invite the next qualified Bidder(s) to enter into a contract. The County also reserves the right to re-bid this project if it is determined to be in its best interest to do so. The County’s right to go to the next qualified Bidder(s) and/or rebid is not limited by the award of a contract or the 120-day period.

NOTICE OF INTENT TO AWARD

At the conclusion of the RFP response evaluation period, all Bidders will be notified in writing by email or US Postal Service mail of the contract award recommendation, if any, by GSA-Procurement. The document providing this notification is the Notice of Intent to Award/Non-Award.

The Notice of Intent to Award/Non-Award will provide the following information:

The name(s) of the Bidder(s) being recommended for contract award; and The names of all other parties that submitted proposals.

The submitted proposals will be made available upon request no later than five calendar days before approval of the award and contract is scheduled to be considered by the Board of Supervisors.

BID PROTEST / APPEALS PROCESS

The County of Alameda prides itself on the establishment of fair and competitive contracting procedures and the commitment made to follow those procedures. The following is provided in the event that Bidders wish to protest the bid process or appeal the recommendation to award a contract once the Notices of Intent to Award/Non-Award have been issued. Bid protests submitted prior to issuance of the Notices of Intent to Award/Non-Award will not be accepted by the County.

Any bid protest must be submitted in writing by 5:00 p.m. on the SEVENTH (7th) calendar day following the date of issuance of the Notice of Intent to Award/ Non-Award, not the date received by the Bidder. The bid protest must be submitted to the office that has been designated for review of protests for this procurement (the Protest Evaluator). For this procurement, the Protest Evaluator is:

GSA–Office of Acquisition Policy ATTN: Contract Compliance Officer 1401 Lakeside Drive, 10th Floor, Oakland, CA 94612 Email: GSA-BidProtests@acgov.org

A bid protest received after 5:00 p.m. is considered received as of the next calendar day. A protest received after 5:00 p.m. on the SEVENTH (7th) calendar day following the date of issuance of the Notice of Intent to Award/Non-Award will not be considered under any circumstances by the Protest Evaluator or their designee.

Generally, the County will promptly send an email acknowledging receipt of the protest; it is the responsibility of the protestor to confirm that the protest was timely received.

The bid protest must contain a complete statement of the reasons and facts for the protest.

The protest must refer to the specific portions of all documents that form the basis for the protest.

The protest must include the name, address, email address, and telephone number of the person submitting the protest on behalf of the protesting party.

The Contract Specialist will send a notification to Bidders if a protest is received.

The Protest Evaluator, or their designee, will review and evaluate the protest and issue a written decision. The Protest Evaluator may, at its discretion, do any of the following: investigate the protest, obtain additional information, provide an opportunity to settle the protest by mutual agreement, and/or schedule a meeting(s) with the protesting Bidder and others (as appropriate) to discuss the protest. The decision on the bid protest must be final prior to the Board hearing.

A notification of the decision will be communicated by email and/or US Postal Service mail to the protestor. Notification will be provided to Bidders when a decision has been made on the protest and whether or not the recommendation to the Board of Supervisors in the Notice of Intent to Award/ Non-Award will stand.

The decision on the bid protest by the Protest Evaluator may be appealed to the Auditor-Controller's Office of Contract Compliance & Reporting (OCCR) located at 1221 Oak St., Room 249, Oakland, CA 94612, Email: OCCR@acgov.org, unless the OCCR determines that it has a conflict of interest in which case an alternate will be identified to hear the appeal and all steps to be taken by OCCR will be performed by the alternate. The Bidder whose bid is the subject of the protest, all Bidders affected by the Protest Evaluator's decision on the protest, and the protestor have the right to appeal if they feel the Protest Evaluator's decision is incorrect. All appeals to the Auditor-Controller's OCCR must be in writing and submitted within SEVEN (7) calendar days following the issuance of the decision, not the date the decision is received by the Bidder. An appeal received after 5:00 p.m. is considered received as of the next calendar day. An appeal received after 5:00 p.m. on the SEVENTH (7th) calendar day following the date of issuance of the decision by the Protest Evaluator will not be considered under any circumstances by the Auditor-Controller OCCR or their designee.

The appeal must specify the decision being appealed and all the facts and circumstances relied upon in support of the appeal.

In reviewing protest appeals, the OCCR will not re-judge the proposal(s). The appeal to the OCCR must be limited to a review of the procurement process to determine if the contracting department materially erred in following the bid or, if applicable, County contracting policies or other laws and regulations.

The appeal to the OCCR must be limited to the grounds raised in the original protest and the written decision by the Protest Evaluator. As such, a Bidder is prohibited from stating new grounds for a Bid protest in its appeal.

The Auditor’s Office may overturn the results of a bid process for ethical violations by Procurement staff, County Selection Committee members, subject matter experts, or any other County staff managing or participating in the competitive bid process, regardless of timing or the…