Att 9 - Submittal Form K Subcontractors.xlsx

XLSX spreadsheet 12 KB Posted

Attached to
Notice of Cancellation RFP 2025-0200-0177 / 02-101-25 Pharmacy Benefit Manager Services
Solicitation number
2025-0200-0177 / 02-101-25
Issued by
Alaska

About this file

This document is a Subcontractors Submittal Form K for a state contract, specifically for the state of Alaska, related to a procurement opportunity involving healthcare or pharmacy services. The form requires potential offerors to disclose their intended use of subcontractors across multiple functional areas including claim processing system, formulary management, appeals, clinical programs, P&T Committee, customer service, rebate contracting, network contracting, mail order pharmacy, specialty pharmacy, and data reporting. During contract negotiation, the state may require written verification of subcontractor commitment and will mandate that subcontractors possess a valid Alaska business license if performing work within the state.

The form provides a structured template for contractors to detail their subcontracting approach, including the ability to specify the percentage of work each subcontractor will perform and their specific service descriptions. While no specific pricing, funding sources, or contract value are outlined in this document, it represents a critical compliance component of the procurement process, ensuring transparency and accountability in how the prime contractor intends to leverage third-party subcontractors to fulfill the contract's requirements. The form's design suggests a comprehensive approach to evaluating and documenting subcontractor involvement across multiple operational domains within what appears to be a healthcare or pharmacy-related contract.

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Other files

File Type Posted
Amd Six RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Notice of Cancellation RFP#2025-0200-0177-02-101-25 Pharmacy Benefit Manager (PBM) Services.pdf PDF
Amd Five RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Amd Three RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Amd Four RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Amd Three Att 10 - Submittal Form L - Cost Proposal Version 2.xlsx XLSX spreadsheet
Amd Two RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Amd One RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Att 1 - Submittal Form A Offeror Information and Certifications.docx DOCX document
Att 4 - Submittal Form G (Part 1 of 2) - Contractual Reqs.xlsx XLSX spreadsheet
Att 3 - Submittal Form F Mandatory Requirements.xlsx XLSX spreadsheet
Att 12 - Submittal Form M (Part 2 of 2) - Financial Requirements Narrative Response Form.docx DOCX document
Att 17 - HIPPA Business Associate Agreement.docx DOCX document
Att 16 - Intent to Propose Form (ITP).xlsx XLSX spreadsheet
Att 11 - Submittal Form M (Part 1 of 2) - Financial Requirements.xlsx XLSX spreadsheet
Att 10 - Submittal Form L - Cost Proposal.xlsx XLSX spreadsheet
Att 14 - Client Reference Form.docx DOCX document
Att 6 - Submittal Form H GeoAccess Analysis.xlsx XLSX spreadsheet
Att 5 - Submittal Form G (Part 2 of 2) - Contractual Reqs Narrative Response Form.docx DOCX document
Att 2 - Submittal Forms B-E.docx DOCX document
RFP 2025-0200-0177 02-101-25 PBM Services.pdf PDF
Att 8 - Submittal Form J Formulary Disruption Analysis.xlsx XLSX spreadsheet
Att 7 - Submittal Form I Network Disruption Analysis.xlsx XLSX spreadsheet
Att 13 - Standard Agreement Form & Appx A-D.pdf PDF
Att 15 - Non-Disclosure Agreement (NDA).docx DOCX document
Show all 25

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Subcontractors

Submittal Form K - Subcontractors
Offeror must complete this submittal form if using subcontractors. During contract negotiation, the State may require a signed written statement from each subcontractor that clearly verifies the subcontractor is committed to performing the services required by the contract. Prior to contract award, the State will also require evidence that a subcontractor possesses a valid Alaska business license if they will be performing work within Alaska.
Offeror must identify all functions that will be outsourced to any third party below:
FunctionOutsource to third party?Subcontractor NameAddressDescription of Services% of Work Performing
Claim processing systemSelect One
Formulary ManagementSelect One
AppealsSelect One
Clinical programsSelect One
P&T CommitteeSelect One
Customer serviceSelect One
Rebate contractingSelect One
Network contractingSelect One
Mail Order PharmacySelect One
Specialty PharmacySelect One
Data ReportingSelect One
Other, please specify
Other, please specify
Other, please specify
Other, please specify
Other, please specify
Other, please specify
Other, please specify
Other, please specify
Other, please specify

File details come from the government source that posted it. Updated .