Attachment F - Pharmacy Claims File

This file is a pharmacy claims dataset supporting the City of Houston's Pharmacy Benefits Management (PBM) Services procurement for its self-funded medical plans. The attachment provides historical pharmacy claims data essential for bidders to understand the volume, types, and costs of prescription drug benefits currently administered for the City's employees and dependents. The claims file enables prospective contractors to analyze utilization patterns, cost trends, and service requirements necessary for developing accurate proposals and implementation plans. The data serves as a baseline for pricing assessments and operational planning during the competitive bidding process for the five-year initial contract term with two optional one-year renewal periods.

The pharmacy claims file represents the incumbent's administrative records and current operational environment, providing transparency regarding claim volumes, drug categories, member demographics, and cost structures that potential bidders must evaluate. This historical data is critical for pricing pharmacy benefits services competitively while ensuring continuity of care for the City's employee population. Access to detailed claims information enables bidders to assess network requirements, formulary management needs, clinical program opportunities, and cost containment strategies specific to the City's membership and utilization profile.