Attachment 14 - GIC 2026 PBM RFR Technical Questionnaire.xlsx

Cover Pharmacy Benefit Manager Request for Responses (RFR)

Commercial & EGWP Populations

Instructions

For Bidders submitting bids for the EGWP population, this will allow us to review those respective capabilities.

Responses will be used to assess both the Bidder’s ability to meet stated requirements and the relative strength of its offering.

The questionnaire includes requirements applicable to:

- General bid and contractual terms

- Operational and clinical services

- Pharmacy claims adjudication

- Pharmacy network management

- Formulary and clinical services

- Rebate administration

- Financial terms

- Performance guarantees

- Fiduciary alignment and client rights

- EGWP capabilities

- GIC-specific requirements

- Complete – address every question and sub-question

- Accurate – reflect the Bidder’s actual standard capabilities and proposed terms

- Specific – avoid vague marketing statements

- Concise but substantive – provide enough detail to support evaluation without unnecessary promotional language

- Consistent – align with pricing, guarantees, implementation approach, and any supporting materials submitted elsewhere in the RFR process

By submitting a proposal, the Bidder is expected to stand behind the representations made in the technical questionnaire and acknowledge that the responses may be used in final evaluation and contract discussions.

Respond directly in the workbook fields provided for each question. Use the required response format shown in the questionnaire, including, as applicable:

- Yes/No confirmations

- Drop-down selections

- Integers

- Percentages

- Short-form narrative responses

- Long-form narrative responses

Preserve question numbering Do not alter the structure of the workbook, rename tabs, overwrite formulas, add columns, hide rows, or change question numbering.

*Numbering Skips: You may come across sections or questions in which the numbers skip. This is intentional and can be disregarded by respondents.*

Use the requested level of detail Where a word limit or answer format is indicated in the questionnaire, Bidders should stay within that intended level of detail. If additional explanation is needed, keep it tightly focused on the requirement being addressed.

Use plain, decision-useful language - refrain from copying large amounts of marketing copy.

Responses should be written so evaluators can quickly determine:

- whether the requirement is met,

- whether the capability is standard or customized,

- whether fees apply,

- whether the response is subject to conditions or limitations, and

- how the capability would function for the GIC specifically.

For open-text questions, Bidders should provide practical, client-specific responses rather than generic marketing language. Strong responses typically include:

- description of the process or capability,

- how the capability would apply to the GIC,

- whether the capability is standard or configurable,

- implementation considerations,

- key controls and accountabilities,

- applicable turnaround times or service levels,

- reporting outputs, and

- any associated fees or rebate impacts.

If a program, feature, or service has any associated fee, rebate impact, implementation cost, integration requirement, or operational dependency, this should be clearly disclosed.

If a Bidder submits information it considers proprietary, confidential, or otherwise exempt from disclosure under applicable public records laws, the Bidder must clearly identify and label such information in its response. Labeling information as proprietary, confidential, or exempt does not, by itself, guarantee that such information will be withheld from disclosure. Any determination regarding disclosure will be made in accordance with applicable law.

2. If the questionnaire asks a direct question, answer it in the workbook. Do not respond with “see attached” in place of a substantive answer unless the question explicitly requests an attachment.

3. Responses should be clear and unconditional unless the question specifically asks the Bidder to explain limitations or deviations. Any assumptions, conditions, or deviations must be disclosed in the response field provided. Undisclosed caveats may be disregarded.

4. Many questions in the Technical Proposal are structured as confirm/do not confirm, yes/no, or other binary compliance statements. For these questions:

- Answer “Yes” only if the Bidder can fully comply as stated.

- If the Bidder cannot comply in full, answer “No” and provide a clear explanation where space is provided.

- Do not answer “Yes” if compliance depends on future negotiation, additional fees, implementation changes, custom development, minimum volume thresholds, market checks, or other conditions unless those conditions are explicitly disclosed and permitted in the response.

5. Where explanatory text is requested for a “No” answer, the Bidder should state:

- the nature of the deviation,

- whether an alternative approach is available,

- operational impact,

- member/client impact,

- financial impact, and

- whether the issue is negotiable.

6. For open-text questions, Bidders should provide practical, GIC specific responses rather than generic marketing language.

7. Where the questionnaire requires an attachment or supporting exhibit, Bidders should provide it in the requested format. Examples from the technical proposal include, where applicable:

- completed pricing terms exhibit

- plan design and clinical program support documentation

- implementation timelines or sample project plans

- denials and appeals flowcharts

- sample claims reporting templates

- account team bios and contact details

- specialty drug lists and limited distribution drug lists

- sample reports or transparency reporting examples All attachments should be clearly labeled and referenced consistently.

8. Bidders should treat the Technical Proposal as a formal representation of their proposed operating model, contractual offering, and service level commitments. The strongest submissions will be those that are complete, transparent, operationally credible, and directly responsive to the needs of the Massachusetts Group Insurance Commission (GIC).

If bidding on EGWP, the Bidder should ensure responses are specific to EGWP administration

Questions should be submitted by the deadline established in the procurement timeline.

The GIC and Mercer may request clarifications if a response is unclear, incomplete, or appears inconsistent. However, bidders should not assume they will have the opportunity to revise a weak or incomplete response after submission.

- compliance scoring for confirm/do not confirm questions,

- evaluator judgment for narrative responses,

- category-level weighting to reflect overall procurement priorities.

In general:

- Full points are awarded where the Bidder fully meets the requirement.

- Partial points may be awarded where the response reflects partial compliance, qualified compliance, or a less favorable response option.

- Zero points may be awarded where the Bidder does not meet the requirement, declines to confirm, does not provide the requested information, or provides a materially deficient response.

Introduction to RFR

1) Comply with instructions exactly as stated for effective review and timely evaluation. Responses should be succinct yet thorough, conforming to the requirements in each section.

2) Limit attachments and exhibits to those requested specifically by Client in this RFP. Any additional attachments will not be part of your submission and may not be referenced during final contract negotiations.

3) Do not submit pricing information, caveats, assumptions, or any responses using other attachments or exhibits. Information submitted in alternative formats to RFP requirements will be deemed immaterial to the bid and will not be referenced during final contract negotiations.

4) Acknowledge that Client’s request for sample contracts (which should address contract requirements), reports, and/or communication materials is not an agreement to accept these documents, or an implied consent to adopt their terms or contents.

5) Submit pricing and pricing assumptions that correspond to the Bid Requirements, Financial Requirements, and Performance Guarantee sections. Client reserves the right to request pricing for alternative or future state plan design administrative options.

6) Assume that Client will maintain similar plan designs, channel management, clinical and administrative edits or programs represented in the clinical program exhibits. Do not assume Client will expand on these strategies and submit any additional plan design offers that are not requested.

7) Agree that costs for program development or customization required conforming to these requirements and/or to administer the program as described will be paid by the Bidder.

8) Bidder's employees must not directly contact Client staff or any of Client’s current vendors/suppliers other than Mercer about the subject matter of this RFP. Violation of this restriction may result in Bidder's disqualification at Client’s sole discretion.

9) Subsequent to issuance of this RFP, additional details may become available and, if it is considered material by Client in its sole discretion, may be transmitted for Bidder's consideration. Bidder will consider any such information in Bidder's proposals and Client will assume that all changes or additional information transmitted have been reflected in the proposal and all pricing therein, unless otherwise specified.

10) It is the policy of Client and the responsibility of its employees to conduct business affairs with the highest standards of integrity and business ethics. In this regard, employees of Client are instructed to avoid even the appearance of impropriety in transactions with outside providers.

11) Client encourages Bidder to ask questions necessary to ensure a clear understanding of the requirements of the RFP. Bidder is strongly encouraged to notify the RFP contacts listed below at the earliest possible opportunity of errors, omissions and other issues identified in the RFP.

12) Vendor confirms that all responses to questionnaire are applicable to respective client. If you are a vendor that was part of Mercer's Annual RFI, vendor confirms that any necessary updates to those responses are accurate otherwise said changes are addressed within this Questionnaire.

13) Agree to keep the information provided herein confidential. This requirement applies whether or not the recipient of the RFP package agrees to bid. Other than reports submitted to either Client or Mercer, the Vendor agrees not to publish, reproduce or in any other way divulge such information in whole or part, in any manner or form, or authorize or permit others to do so. Please do not divulge the contents of your proposal to any Client personnel other than those receiving copies of your proposal as outlined in this RFP. This stipulation is neither to impede nor inhibit your marketing or sales activity, but rather to ensure the confidentiality of your bid.

14) Agree that this RFP shall not be construed in any manner to create an obligation on the part of Client to enter into any contract or to serve as a basis for any claim whatsoever for reimbursement of costs for efforts expended by the Vendor. This RFP may be withdrawn or canceled by Client at any time, and Client reserves the right to reject any or all proposals submitted hereunder for any reason whatsoever.

15) Bidder shall be solely responsible for all costs and expenses incurred in the preparation and presentation of its response to this RFP, including without limitation market research and attendance at meetings.

16) Final award of business is contingent on contract being finalized after provisional award of business and can be rescinded if final terms are not agreed upon.

By submitting a proposal Bidder agrees to all requirements outlined above.

1.6 Proposal Requirements

The below outlines the key offer elements for which bidders are requested to submit pricing and proposals. Bidders should base their responses on the population, plan design structure and integration requirements as well as the individual plan design elements and clinical programs provided with this RFP. The EGWP prescription drug plan may vary due to Medicare requirements, please refer to the applicable Plan Summary Exhibits for this population.

: Confirm/Do Not Confirm 1.6.R2C2 Integrate with the following medical carrier(s): Mass General Brigham Health, Health New England, Wellpoint, and Point32 (Harvard Pilgrim Access America and Tufts Health Plan)

: Confirm/Do Not Confirm 1.6.R3C2 Integrate with the GIC's in house eligibility administrator : Confirm/Do Not Confirm 1.6.R4C2 Data integration with the following point solution vendors: Hinge Health : Confirm/Do Not Confirm 1.6.R5C2 Financial Offer Type: Most financially competitive 3-year pricing offer : Confirm/Do Not Confirm 1.6.R6C2 Initial term of three (3) years from the Plan Effective Date and thereafter may renew at GIC discretion for two (1) year terms : Confirm/Do Not Confirm 1.6.R7C2 Submit proposals on a bundled carved-out pharmacy management model : Confirm/Do Not Confirm 1.6.R8C2 Formulary with Exclusions : Confirm/Do Not Confirm 1.6.R9C2 Exclusive Specialty with 1 courtesy/grace fills - effective 07/01/2026, with the implementation of PrudentRx, changed to 0 courtesy/grace fills : Confirm/Do Not Confirm 1.6.R10C2 Broad Retail Network : Confirm/Do Not Confirm 1.6.R11C2 Broad Retail 90 Network : Confirm/Do Not Confirm 1.6.R12C2 Voluntary Retail 90 (member option to opt out) : Confirm/Do Not Confirm 1.6.R13C2 Utilization Management : Confirm/Do Not Confirm 1.6.R14C2 Coupon Maximizer Program : Confirm/Do Not Confirm 1.6.R16C2 Price Protection / Discount Card Match Program : Confirm/Do Not Confirm

PBM RFR Questionnaire- The GIC

1: Yes, no conditions must be met before payments are issued, 2: Yes, requires interim documentation (e.g., letter of agreement), 3: Yes, requires finalized negotiated contract terms and only signatures are pending, 4: No, requires executed contract.

2.1.2 Bidder agrees that no later than 30 days after notification of a contract award, Bidder will provide an accurate draft of the contract for the GIC's review. For purposes of this requirement, accuracy will be defined as the inclusion of all final pricing, contractual and performance guarantees negotiated as part of this RFP. Pull-down list 1: Yes, 2: No

2.1.3 Bidder's proposal will not require any changes to the GIC’s current plan design, clinical management programs or other UM rules outlined in this RFP. Any proposed changes to the GIC’s plan design, clinical and utilization management programs will be accompanied by the GIC specific analyses of the cost and Participant impact of the proposed change; this includes the impact to rebates, if any. Pull-down list 1: Yes, 2: No

2.1.4 Bidder agrees to honor the responses outlined in this proposal without any alterations, regardless of whether the final terms are outlined in the contract. Pull-down list 1: Yes, 2: No

2.1.5 Any assumptions and caveats related to the financial offer must be detailed in the space provided. No additional documents will be accepted and therefore, they will be non-binding. Bidder confirms no additional documents or language within those documents provided as part of this RFP will be contractually binding. Pull-down list 1: Yes, 2: No

2.1.6 Bidder agrees to be bound by its proposal from the date submitted until the effective date of the contract, during which time the GIC may request clarification or correction of the proposal for evaluation purposes. Amendments or clarifications shall affect only that portion of the proposal so amended or clarified. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

2.2.2 The GIC will have the right to terminate the agreement for convenience at any time, upon 90 days' written notice, without any penalty, termination fees, damages, rebate retention, delayed rebate payments, or repayment of pharmacy credits. Pull-down list 1: Yes, 2: No

2.2.3 Upon termination of any contract, Bidder will provide all necessary documentation and data needed for the successful transition of the program/services to another Bidder at a mutually agreed timeframe and at no additional cost. Pull-down list 1: Yes, 2: No

Attachment 15a – Plan Design & Clinical Programs Document – Commercial Attachment 15b – Plan Design & Clinical Programs Document – EGWP Attachment 16a – Financial Proposal – Commercial Attachment 16b – Financial Proposal – EGWP Pull-down list 1: Yes, 2: No

1: Yes, 2: No

3.1.2.2 If Bidder proposes to offshore any services during the term of the contract (after the effective date), Bidder agrees to give the GIC at least 90 days' notice and the option to decline offshoring without any impact to pricing. Pull-down list 1: Yes, 2: No

1: Claims Adjudication 2: Retail Pharmacy Network Management 3: Mail Distribution 4: Specialty Distribution 5: Call Center 6: ID Cards 7: Formulary Development 8: Clinical Criteria Development 9: Clinical Management 10: Patient Counseling 11: Denials and Appeals 12: Rebate Aggregator 13: Other

1: Yes, 2: No

3.1.3.2 Bidder performs at least annual systems testing to ensure all data is secure and has security measures in place to protect Participant Personally Identifiable Information (PII) accessed remotely by employees. Pull-down list 1: Yes, 2: No

3.1.3.3 Bidder will notify the GIC without undue delay and in no event later than twenty‑four (24) hours after discovery of any actual or suspected data breach. Upon request, Bidder will provide the GIC the identities of individuals who receive breach notification (to the extent permitted by law). These requirements shall override and take precedence over any other agreements, and may not be limited by such agreements. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.4.4 Bidder confirms there is a back-up location for Customer Service should the primary location go down for any reason or receives excessive number of calls. Pull-down list 1: Yes, 2: No

3.1.4.5 Bidder confirms its Customer Service team will be knowledgeable regarding the GIC's specific plan design/pharmacy benefit programs and any integration with medical coverage to respond to Participant questions. Pull-down list 1: Yes, 2: No

3.1.4.6 Bidder confirms that its IVR and website will be available 24/7/365 and provide information relevant to the service(s) provided and customized to the GIC's plan designs and programs, including but not limited to claims information, pricing, pharmacy locator, formulary, drug information. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.4.8 Confirm Bidder can track and record all interactions to ensure consistency and accuracy of information provided by your Customer Service Representatives (CSR) to the GIC's Participants. Pull-down list 1: Yes, 2: No

3.1.4.9 Confirm Bidder can record all calls transferred within your own organization (i.e. warm transfer to specialty, mail order, etc.). Pull-down list 1: Yes, 2: No

1: Yes, 2: No

3.1.5.2 If requested, Bidder will allow pre-approval of satisfaction survey by the GIC. Pull-down list 1: Yes, 2: No

3.1.5.3 Bidder does not subcontract customer satisfaction surveys. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

3.1.6.2 Bidder will provide standard customization of Participant communication materials and/or enrollment materials at no additional cost to the GIC. Standard customization includes, but not limited to, client branding, content edits, format adjustments and other routine customizations. Bidder must clearly identify any content that cannot be modified due to legal or regulatory requirements. Pull-down list 1: Yes, 2: No

3.1.6.3 The GIC will review and approve all Bidder communications before being sent to Participants and will be given at least two (2) weeks' notice prior to any communications taking place. Pull-down list 1: Yes, 2: No

3.1.6.4 All communication materials distributed to Participants will be available upon request on Bidder web site. Pull-down list 1: Yes, 2: No

3.1.6.5 Bidder's web site can incorporate the GIC's other benefit information (e.g., point solutions, medical carriers, etc.) at no charge in an effort to communicate links to the GIC's other Bidders and benefits (hyperlinks, single sign-on, etc.). Pull-down list 1: Yes, 2: No

3.1.6.6 If requested, Bidder will provide a direct link to Bidder's member website from the GIC's company website utilizing a single sign on (SSO), and at no charge including all implementation, configuration and ongoing maintenance. For clarity, “no additional cost” means the service must be provided without fees or pricing adjustments based on client size, level of customization or inclusion in financial proposals. Pull-down list 1: Yes, 2: No

3.1.6.7 Bidder has multilingual telephonic, electronic and print capabilities with no additional charges to the GIC. Pull-down list 1: Yes, 2: No

3.1.6.8 Bidder has an active Diversity, Equity, and Inclusion (DE&I) policy in place for member Please detail your organization's current compliance posture with respect to federal digital accessibility mandates, including Section 504 and Section 508 of the Rehabilitation Act, Section 1557 of the Affordable Care Act (ACA), and Title II of the Americans with Disabilities Act (ADA).

Specifically, confirm that all member-facing digital assets, downloadable documents, and dynamic electronic resources provided under this contract—including but not limited to drug formularies (PDF/HTML), Explanation of Benefits (EOBs), mobile applications, password-protected member portals, and pharmacy locator tools adhere to the Web Content Accessibility Guidelines. Pull-down list 1: Yes, 2: No

3.1.6.9 Confirm Bidder's alignment with Massachusetts-specific civil rights and procurement standards, including the Massachusetts Equal Rights Act, the State Public Accommodations Law, and the newly issued Commonwealth of Massachusetts Statewide Digital Accessibility and Equity Strategic Plan.

Certify that all digital deliverables under this contract comply with the Commonwealth's Enterprise Information Technology Accessibility Standards. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.7.2 Bidder will provide the GIC with a de-identified summary of pharmacy-related issues from the call center issue tracking database upon request. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.7.4 Bidder resources attending benefit fairs and onsite employee events must be core competent in the GIC's plan design and will not be outsourced. Pull-down list 1: Yes, 2: No

3.1.7.5 Bidder confirms it will provide support and coordination of care with designated disease or care management programs. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.7.7 Bidder agrees, if applicable to the services it provides, to notify the GIC of any class action suits related to prescriptions drugs. Pull-down list 1: Yes, 2: No

3.1.7.8 Bidder will supply necessary data for the GIC or its third party to file a claim for class action suits at no cost to the GIC. Pull-down list 1: Yes, 2: No

3.1.7.9 All programs selected by the GIC will include quarterly reporting showing the fees, number of Participant specific encounters, the impact of such encounters and outcomes including any savings. Pull-down list 1: Yes, 2: No

1: Yes, 2: No 3.1.7.10.R2C1 (b) net of fees

Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.7.11 Bidder confirms it will assign a designated account team for the following roles, for each contract (Commercial, and EGWP as applicable):

(a) Executive Sponsor

(b) Account Executive/Director

(c) Account Manager (day to day person)

(d) Account Coordinator

(e) Pharmacist/Clinical Program Director

(f) Financial Analyst Pull-down list 1: Yes, 2: No

3.1.7.12 For the account team(s) assigned, please provide copies of their professional bios, full contact information (including: name, title, location, email and phone).

1: Yes, 2: No

3.1.7.14 Bidder confirms that the GIC can request replacements of the Bidder's account management team and/or implementation team, if dissatisfied with the performance of assigned account team. Bidder will confirm it will comply with the GIC’s request and make every effort to provide a qualified replacement, subject to the GIC’s approval, within two weeks. Pull-down list 1: Yes, 2: No

1: Yes, included in annual audit at no cost with no limitations on type and scope 2: Yes, included in annual audit at no cost with limitations on type and scope of annual audit as described 3:Yes, full audit rights permitted but not included at no cost; fee applies as described 4: No, full audit rights not permitted as described

3.1.8.2 Bidder agrees to fully support any audit, including providing all documentation, records, data extracts and any other information reasonably required for the GIC or a third-party representative to conduct the audit. Pull-down list 1: Yes, 2: No

3.1.8.3 The GIC can choose a reasonable place, time, and duration of any audit with appropriate written notice. This includes no limitation on the number of contract years that may be audited and no restriction limiting audits to only the most recent contract year, at no additional cost. For clarity, any Bidder blackout periods or scheduling restrictions will be addressed separately and should not be considered a limitation for the purposes of this question. Pull-down list 1: Yes, 2: No

3.1.8.4 Bidder confirms that there is no black out period for non-implementation audits. Pull-down list 1: Yes, 2: No

1: Yes, 2: No 3.1.8.5.R3C1 (c) Confirm the types of audit activities it will accommodate during the black out period.

1: Yes, 2: No

3.1.8.7 Audit rights shall survive termination, including early termination, of the service agreement for a minimum of 24 months after the termination date. Pull-down list 1: Yes, greater than or equal to 24 months 2: Yes, greater than 12 months but less than 24 months 3: Yes, up to 12 months 4 No, no survival rights

3.1.8.8 Audit periods may include up to two (2) consecutive calendar years at no cost to the GIC. Pull-down list 1: Yes, 2: No

3.1.8.9 If the GIC has performance concerns due to a violation of law or regulation, a systemic issue affecting multiple Bidder clients, or material error and the GIC deems it necessary to conduct an audit, the auditors will be selected by the GIC with all audit costs incurred by Bidder. Pull-down list 1: Yes, 2: No

3.1.8.10 Bidder confirms that the GIC can conduct audits at any time during the contract term upon 30 days' written notice (except during a blackout period if disclosed in this RFI). Pull-down list 1: Yes, 2: No

3.1.8.11 Bidder will provide a corrective action plan within 30 days of an audit that identifies error, value, and member impact. Pull-down list 1: Yes, 2: No

3.1.8.12 If audit discrepancy is a result of human error which requires additional training, training shall be completed within 60 days of receipt of the final audit findings and the GIC shall be notified of this completion. Pull-down list 1: Yes, 2: No

3.1.8.13 Bidder will allow the GIC or its designee the ability to independently review the specialty program including any and all paid claims and documented patient and provider interventions to verify comprehensiveness and effectiveness of services provided. Pull-down list 1: Yes, 2: No

3.1.8.14 Bidder confirms that the GIC or its designee the right to independently audit the implementation and administration supporting any patient assistance programs, including but not limited to copay card and drug specific cost-reduction programs, or any other such offerings that result in adjustments to the drug cost, member cost share and/or the GIC cost share of prescription transactions. Pull-down list 1: Yes, 2: No

3.1.8.15 Bidder agrees that the GIC will not be responsible nor assess a charge for any Bidder expenses related to CMS compliance audits, including the costs to provide necessary records. Pull-down list 1: Yes, 2: No

3.1.8.16 Bidder agrees to "hold harmless" the GIC for audit liabilities because of Bidder's management of the retiree drug program including any penalties imposed by CMS. Pull-down list 1: Yes, 2: No

3.1.8.17 Bidder will support 100% electronic claims audit with no limitation on the number of claim samples Bidder will review. (if claims audit sample size limitation is required, please provide sample size limit).

1: Yes, 100% claims audit with no sample size limitation 2: Yes, 100% claims audit with sample size of greater than 300 3: Yes, 100% claims audit with sample size of 300 or less 4: No Pull-down list 1: Yes, 2: No

3.1.8.18 The GIC or its designee can audit onsite facilities and perform call monitoring at Bidder sites, including those of Bidder subsidiaries.

Single, Radio group.

1: Yes, included in annual audit at no cost with no limitations on type and scope 2: Yes, included in annual audit at no cost with limitations on type and scope of annual audit as described 3:Yes, audits permitted but not included at no cost; fee applies as described 4: No, audit rights not permitted as described Pull-down list 1: Yes, included in annual audit at no cost with no limitations on type and scope 2: Yes, included in annual audit at no cost with limitations on type and scope of annual audit as described 3:Yes, audits permitted but not included at no cost; fee applies as described 4: No, audit rights not permitted as described

1: Yes, 2: No

3.1.9.2 Bidder certifies that, while the GIC retains ERISA fiduciary responsibility, the Bidder accepts full accountability for the accuracy, compliance and performance of the services it provides including compliance with all applicable federal and state requirements (ERISA, HIPAA, CAA and DOL regulations, etc.). Pull-down list 1: Yes, 2: No

3.1.9.3 The parties agree that as it relates to use and disclosure of PHI, electronic transaction standards and security of electronic PHI under the Health Insurance Portability and Accountability Act of 1996, as amended, they are subject to the terms of the Business Associate Agreement negotiated separately between the parties. Notwithstanding the foregoing, the parties acknowledge that in providing services to Members, Bidder Specialty Pharmacy and the Mail Service Pharmacy are acting as separate health care provider covered entities under HIPAA and not as business associates to the Plan covered by the Business Associate Agreement. In providing services, Bidder Specialty Pharmacy and the Mail Services Pharmacy shall abide by all HIPAA requirements applicable to covered entities and shall safeguard, use and disclose Member PHI accordingly. Pull-down list 1: Yes, 2: No

3.1.9.4 Bidder agrees to act in compliance with all state and federal regulations for the duration of any agreement with the GIC, including all renewals, extensions, amendments and successor agreements. Pull-down list 1: Yes, 2: No

3.1.9.5 Bidder has a process for monitoring state and federal legislation, regulations and/or laws that impact pharmacy benefit services and/or the GIC and its members. Pull-down list 1: Yes, 2: No

3.1.9.6 Bidder will provide a summary and operational interpretation of any new state or federal legislation, regulations and/or laws and possible impact to the GIC within thirty (30) days of such legislation being passed and any updates as needed prior to effective date outlining expected operational impacts. Such interpretation is intended for informational and operational purposes only and does not constitute legal advice. Pull-down list 1: Yes, 2: No

3.1.9.7 Bidder will notify the GIC immediately if Bidder violates a law and/or regulation or Bidder has a systemic issue affecting the GIC. Pull-down list 1: Yes, 2: No

3.1.9.8 Bidder agrees they're willing to meet and adhere to the 2026 Consolidated Appropriations Act's PBM transparency and reporting requirements beginning at the start of the contract term, in advance of the federal implementation of 01/01/2029. Pull-down list 1: Yes, 2: No

1: Yes, 2: No

1: Yes, 2: No

3.1.10.2 Bidder agrees that the GIC will have up to 30 business days to pay any administrative invoice. Pull-down list 1: Yes, 2: No

3.1.10.3 If the GIC disputes an invoice within the payment window, the GIC will not be required to pay the disputed portion until resolution. Pull-down list 1: Yes, 2: No

3.1.10.4 In the event of Bidder error or oversight, Bidder confirms it will NOT charge the GIC after the normal claims and/or administrative fee billing cycles have ended for the contract year. Pull-down list 1: Yes, 2: No