GICPND2604 Notice of Intent FINAL.pdf

Notice of Intent to Release Pharmacy Benefit Manager RFR (Commercial & EGWP)

May 29, 2026

The Commonwealth of Massachusetts Group Insurance Commission (the GIC) intends to post a combined Request for Response (RFR) to procure a Pharmacy Benefit Manager (PBM) for both its Commercial and Employer Group Waiver Plan (EGWP) populations. The GIC’s objective is to secure best-in-class clinical, financial, and operational PBM capabilities that deliver high-quality member care and sustainable cost management.

Important instructions for prospective bidders

• Do not contact the Purchaser about the content of the anticipated RFR prior to its release. Bidders are solely responsible for monitoring the COMMBUYS posting for the complete RFR and any subsequent amendments.

• Bidders may monitor the posting using COMMBUYS public search and browse tools or by subscribing to

COMMBUYS email notifications and record tracking. To receive notifications for this RFR, ensure the following commodity codes are included in your COMMBUYS profile: 80-10-00-00 (Management Advisory Services) and/or 84-13-00-00 (Insurance and Retirement Services). To subscribe, select Register at commbuys.com and complete the online registration process.

About the GIC

The GIC was established by the Massachusetts legislature in 1955 to provide and administer health insurance and other benefits for Commonwealth employees, retirees, their dependents, and survivors. The GIC also provides coverage for participating municipalities, certain housing and redevelopment authority personnel, and certain retired municipal employees and teachers. The GIC is a quasi‑independent state agency governed by a 17‑member Commission appointed by the Governor; the Commission approves most GIC initiatives, benefit changes, and rates. Currently, the GIC provides health insurance coverage for over 260,000 enrollees, covering more than 420,000 people in total, including over 120,000 Medicare participants.

Current program and contract scope

• The GIC contracts with four carriers to offer twelve health plans across their active/non‑Medicare and

Medicare-eligible retiree populations.

• Current PBM administration: CVS Health (Caremark) for Commercial (active employees and non‑Medicare retirees) and a separate EGWP contract for Medicare plan members.

• Additional plan information is available on the GIC website mass.gov/GIC.

Estimated membership and annual gross costs

• Commercial (active/non‑Medicare): ~305,133 members; annual pharmacy gross costs ≈ $830,613,273

• EGWP (Medicare eligible retirees): ~120,011 members; annual pharmacy gross costs ≈ $736,708,269

• Contract start date for both Commercial and EGWP services: July 1, 2027

Interested vendors may bid on either or both of the Commercial and EGWP contracts; however, each contract will be priced and evaluated separately.

• Bidders must demonstrate substantial, documented experience managing large-scale pharmacy benefit programs, including:

- Proven clinical programs and outcomes.

- Robust financial controls, transparent reporting, and effective cost-management strategies.

- Operational excellence in network management, pharmacy operations (retail, mail, specialty), and member/customer service.

- Experience implementing and administering large EGWP arrangements.

• Bidders must confirm compliance with Massachusetts’ 2025 PBM law and Division of Insurance (DOI) licensing.

http://www.commbuys.com/ https://www.mass.gov/orgs/group-insurance-commission

The full RFR will be available via COMMBUYS on or about Wednesday, July 8, 2026, at commbuys.com.

• RFR file number: BD-26-1049-GIC00-07GIC-130036

• RFR title: “GICPND2604 Procuring a Pharmacy Benefit Manager for the Group Insurance Commission”

• Tentative schedule (please note the RFR will state the definitive submission deadline and final schedule)

- RFR release: on or about Wednesday, July 8, 2026

- Bidders’ conference (tentative): Wednesday, July 29, 2026

- Response deadline (tentative): Wednesday, August 5, 2026

Questions regarding the RFR should be directed to:

• Jannine Dewar at jannine.dewar@mass.gov (GIC)

• Jasmyn Plasencia at Jasmyn.Plasencia@mercer.com (Mercer, advising the GIC)

The GIC reserves the right to reject any or all responses, or to accept any proposal or portion thereof, as deemed to be in the best interest of the Commonwealth and its insured.

Matthew Veno Executive Director Group Insurance Commission http://www.commbuys.com/