PBM 122436 O5- Addendum Two- Questions and Answers- Round Two V2.pdf

SPB Form 26 Last Revised 4-17-2025

SOLICITATION ADDENDUM TWO

QUESTIONS AND ANSWERS

SOLICITATION NUMBER: 122436 O5

Administrative Support Services for the State of Nebraska Employee Health Care Prescription Drug Benefit Plans

Opening Date: July 17, 2025 Addendum Effective Date: July 9, 2026

Questions and Answers

Following are the questions submitted and answers provided for the above-mentioned solicitation.

The questions and answers are to be considered as part of the solicitation. It is the responsibility of bidders to check the State Purchasing Bureau website for all addenda or amendments.

Question Number

RFP

Section

Reference

RFP

Page

Number

Question State Response

1. Prescription Drug Benefits Plan RFP

– 1. b.ii. The “Contractual Agreement Form” must be signed manually in ink or by DocuSign…

Pg. 9 Will a digital signature fulfill this request? DocuSign and an ink signature are both approved ways to complete the signature requirement process.

2. Prescription Drug Benefits Plan RFP

– Vendor Duties G. Prices

Pg. 31 How does section G. relate to the pharmacy contracts? What does the 3.5% apply to? Is this in relation to pharmacy fees?

The 3.5% refers to the maximum ASO increase in fees following the initial contract period, for the remainder renewal years.

3. Prescription Drug Benefits Plan RFP

– Project Description and Scope of Work F.

Plan Requirements Q.#9

Pg. 47 Is this referring to an audit or do you want to confirm we’re adjudicating claims properly?

This plan requirement refers to the bidder’s claims adjudication processes.

4. Claims File N/A It appears there is no formulary status provided in the claims file. Can you please provide an updated file with formulary status?

An updated file including formulary status was provided on July 2, 2025,to bidders with a confirmed NDA on file.

5. N/A N/A What are the top 10 retail pharmacies (by claim volume), and what percentage of claims is filled at each?

Refer to the claims file provided to identify pharmacies utilizing the pharmacy ID of each claim.

6. N/A N/A Please provide monthly volume of member calls handled by the call center.

The monthly volume for 23- 24 Plan Year is 965.

The monthly volume for 24- 25 Plan Year is 1,023.

7. N/A N/A Please provide the average number of prior authorizations, appeals, and grievances per month (or annually).

The annual pharmacy appeals for CY2023 were 352.

The annual pharmacy appeals for CY2024 were 395.

Approximately 98% of the appeals were for clinical coverage determinations and excluded medications.

The number of prior authorizations is not available at this time.

8. N/A N/A What is the client's ERISA status?

Please provide the average number of DMRs direct member reimbursement) per month (or annually).

The State of Nebraska plan is not subject to ERISA

There were 40 DMR claims in the most recent 12 months ending 6/30/2025

9. N/A N/A Are there any in-house pharmacies? If so, please provide the NPI.

The State does not have in-house pharmacies.

10. 122436 O5 Prescription Drug Benefits Plan RFP State of NE-

VI. Solicitation Response Instructions-

b. Financial Statements

Pg. 28

As a privately held company, [REDACTED] only releases its audited financial statements to a potential client’s direct financial contact.

Please provide the name and contact method for a financial contact for [REDACTED] to submit the requested documents.

All files are requested to be uploaded via ShareFile.

Confidential files should be uploaded in a separate file named conspicuously as

"PROPRIETARY

INFORMATION". Only the reviewee for the financials will be granted access to review these labeled files and they will not be shared.

11. 122436 O5 Prescription Drug Benefits Plan RFP State of NE- VI. Solicitation Response Instructions-

h. Summary of Bidder’s Corporation Experience

Pg. 29

The State says “The bidder should provide a summary matrix listing the bidder’s previous projects similar to this Solicitation in size, scope, and complexity. “

Does this mean termed or active projects?

The State of Nebraska is interested in a summary of an active/existing project.

This addendum will be incorporated into the solicitation.

12. 122436 O5 Prescription Drug Benefits Plan RFP State of NE- VI. Solicitation Response Instructions-

j. Subcontractors

Pg. 30

If the bidder intends to subcontract any part of its performance hereunder, the bidder should provide:

“ f) percentage of performance hours intended for each subcontract; and

g) total percentage of subcontractor(s) performance hours.”

Does the State want BOB or client specific information?

Please provide client specific information based on the proposal specific to the State of Nebraska.

13. 122436 O5 Prescription Drug Benefits Plan RFP State of NE-

IV. Payment, Pg.22

The State shall have forty-five (45) calendar days to pay after a valid and accurate invoice is received by the State.

Can the State confirm this refers to claims payments as well?

Currently the state reimburses the current vendor within 3 business days for claims and pays ASO fees monthly. The State cannot pay for services until they are rendered.

14. 122436 O5 Prescription Drug Benefits Plan RFP State of NE-

V. Project Prescription and Scope of Work

Pg. 24

The bidder should provide the following information in response to this Solicitation.

Can the State clarify if this section is informational or does the State require responses?

Bidders should provide responses to the information/requirements detailed in Section V as part of their solicitation response.

15. 122436 O5 Prescription Drug Benefits Plan RFP State of NE- VI. Solicitation Response Instructions-2.

Technical Response

Pg. 31

a) Understanding of the project requirements;

b)Proposed development approach;

c)Technical requirements;

Are these sections meant to be addressed in a separate document?

No, the intent of this section was informational.

16. 122436 O5 Prescription Drug Benefits Plan RFP State of NE- VI. Solicitation Response Instructions-2.

Technical Response; h & i.

Pg. 31

1. TECHNICAL RESPONSE

The Technical Response section of the solicitation response should consist of the following subsections:

h. Detailed project work plan; and

i. Deliverables and due dates.

Can the State please clarify what deliverables are expected?

The deliverable for the detailed project work plan is a document, including detailed project tasks, and key milestones and dates.

The deliverables and due dates may be incorporated into the project work plan.