Att 6 - Submittal Form H GeoAccess Analysis.xlsx
XLSX spreadsheet 530 KB Posted
- Solicitation number
- 2025-0200-0177 / 02-101-25
- Issued by
- Alaska
About this file
This file is a Submittal Form H GeoAccess Analysis spreadsheet for a pharmacy network access procurement, likely for a state or local government healthcare benefits program. The document contains three distinct sections for analyzing pharmacy network access across different participant groups: Active Employee Plan, Non-EGWP Retiree Plan, and EGWP with Wrap Plan. The form requires offerors to complete detailed geographic analysis tables that capture pharmacy network accessibility in urban/suburban and rural areas, including metrics such as total plan participants, number of in-network pharmacies, matched and unmatched participants, and average distance to in-network pharmacies.
The analysis requires precise documentation of pharmacy network coverage using census files, which will be provided upon submission of ITP and NDA forms as specified in RFP Section 3.18. The spreadsheet is designed to comprehensively evaluate pharmacy network adequacy by ZIP code and state, with specific focus on measuring access within 5 miles for urban/suburban areas and 10 miles for rural areas. Offerors must demonstrate their ability to provide accessible pharmacy networks across different populations, including active employees, non-EGWP retirees, and EGWP with Wrap Plan participants, by detailing the geographic distribution and proximity of their in-network pharmacies.
View the file
Other files
Show all 25
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Network Access_Employee
| Submittal Form H - GeoAccess Analysis |
| Retail Network Access - Active Employee Plan |
| Offeror must complete the following table based on a standard GeoAccess analysis of the offeror's proposed retail pharmacy network using the Census Files that will be provided upon the submission of the ITP and NDA forms as detailed in RFP Section 3.18 Nondisclosure and Confidentiality. Use commercial pharmacy plan enrollment for the Active Employee population only. | |||||||||||||||
| Area | Access Standard | ||||||||||||||
| Urban/Suburban Areas | 1 within 5 miles | ||||||||||||||
| Rural Areas | 1 within 10 miles | ||||||||||||||
| Urban/Suburban | Rural | Total | |||||||||||||
| Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | ||||||||||
| 5-Digit ZIP Code | State | Total Number Plan Participants | Total Number of In-Network Pharmacies | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy |
Network Access_NonEGWP
| Submittal Form H - GeoAccess Analysis | |||||||||||||||
| Retail Network Access – Non-EGWP Retiree Plan | |||||||||||||||
| Offeror must complete the following table based on a standard GeoAccess analysis of the offeror's proposed retail pharmacy network using the Census Files that will be provided upon the submission of the ITP and NDA forms as detailed in RFP Section 3.18 Nondisclosure and Condifentiality. Use commercial pharmacy plan enrollment for the non-EGWP Retiree population only. | |||||||||||||||
| Area | Access Standard | ||||||||||||||
| Urban/Suburban Areas | 1 within 5 miles | ||||||||||||||
| Rural Areas | 1 within 10 miles | ||||||||||||||
| Urban/Suburban | Rural | Total | |||||||||||||
| Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | ||||||||||
| 5-Digit ZIP Code | State | Total Number Plan Participants | Total Number of In-Network Pharmacies | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy |
Network Access_EGWP
| Submittal Form H - GeoAccess Analysis | |||||||||||||||
| Retail Network Access - EGWP with Wrap Plan | |||||||||||||||
| Offeror must complete the following table based on a standard GeoAccess analysis of the offeror's proposed retail pharmacy network using the Census Files that will be provided upon the submission of the ITP and NDA forms as detailed in RFP Section 3.18 Nondisclosure and Confidentiality. Use EGWP with Wrap Plan enrollment only. | |||||||||||||||
| Area | Access Standard | ||||||||||||||
| Urban/Suburban Areas | 1 within 5 miles | ||||||||||||||
| Rural Areas | 1 within 10 miles | ||||||||||||||
| Urban/Suburban | Rural | Total | |||||||||||||
| Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | Participants Matched | Participants Not Matched | ||||||||||
| 5-Digit ZIP Code | State | Total Number Plan Participants | Total Number of In-Network Pharmacies | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy | Number of Participants | Average Distance to In-Network Pharmacy |
File details come from the government source that posted it. Updated .