Amd Four RFP 2025-0200-0177 02-101-25 PBM Services.pdf

This is Amendment Four to an RFP issued by the State of Alaska, Department of Administration, Division of Retirement and Benefits, for Pharmacy Benefit Manager (PBM) Services (RFP 2025-0200-0177 / 02-101-25). The amendment, dated December 3, 2025, provides questions and answers from potential offerors regarding the procurement. The solicitation seeks a PBM to provide comprehensive services for the State's AlaskaCare health plans covering three distinct populations: active employees, non-EGWP retirees, and EGWP with Wrap participants, serving approximately 86,900 members with annual prescription volumes exceeding 1.6 million claims. The contract term runs from January 1, 2027, through December 31, 2029, with eight potential one-year renewal options and a six-month implementation period. The proposal deadline is December 15, 2025, at 11:00 AM Alaska Time, with the last day for question submittal having been November 10, 2025. Mandatory qualifications require at least three years of experience serving five plan sponsors with 5,000 covered lives, including one state or public sector client.

Amendment Four addresses two key questions submitted by potential offerors. The first question concerns whether Alaska has opted out of any standard PBM formulary exclusions for the active population over the past five years; the State clarified that historical formulary or clinical decisions are not included in the RFP, with the claims file providing a comprehensive overview of current drug mix. The second question addresses recommendations for balancing deidentification with portal functionality presentations; the State responded that offerors are responsible for ensuring compliance with anonymity requirements outlined in the RFP and must use their best judgment with no additional guidance provided. All offerors must sign and return the amendment's first page with their proposal to avoid rejection. The estimated budget ranges from $65 million to $85 million, with proposals exceeding $100 million considered non-responsive, and the State requires 100% pass-through of rebates for all three plans. The current PBM contractor is Optum Rx, with the existing contract in place since January 1, 2019.