Central Purchasing

AMENDMENT OF SOLICITATION

GENERAL INFORMATION

Pursuant to OAC 260:115-7-30(d), this document shall serve as official notice of amendment to the solicitation identified above. Such notice is being provided to all suppliers to which the original solicitation was sent.

Suppliers submitting bids or quotations shall acknowledge receipt of this solicitation amendment prior to the hour and date specified in the solicitation by doing one of the following:

1. Sign and return a copy of this amendment with the solicitation response being submitted.

2. If the supplier has already submitted a response, this acknowledgement must be signed and returned before the solicitation deadline. All amendment acknowledgements submitted separately shall have the solicitation number and bid opening date printed clearly in the subject line of the email.

Return to:

Contracting officer Samantha Fox Phone 405-522-6266 Email Samantha.fox@omes.ok.gov

DESCRIPTION OF AMENDMENT

a. This is to incorporate the following:

On behalf of the State of Oklahoma, OMES gives notice of:

A video recording of the Pre-Bid Conference can be found here: https://www.youtube.com/watch?v=-hUERzgKl8o

The following RFP documents have been added:

Exhibit 10 – SB 1447 Certification

The following questions concerning this solicitation, were received during the Q&A period, which closed on 08/24/2026. All questions and responses are detailed as follows:

1. Regarding Section 3.1.0.7, understanding EGID would consider an EGWP program via a subcontractor, would EGID also consider a commercial-only proposal, awarding the commercial and EGWP contracts to two separate vendors/primary contractors?

The bidder cannot submit a commercial-only proposal. The qualified bidder must offer both commercial and EGWP proposals. If a primary bidder offers commercial bid; it must identify an EGWP subcontractor in conjunction with the primary contractor, vice versa. The primary contractor will be responsible for all aspects of the subcontractor relationship, including, but not limited to financial, performance, and service guarantees.

2. Pre-proposal Conference Call Question: We asked if bidders could propose a PMPM offer only, or if EGID is requiring a traditional pass-through proposal as the primary? Please provide a response asap so we can effectively plan the approach and be prepared to submit by the due date.

Bidders may propose a PMPM-only offer, particularly where the proposal includes a strong assumption of risk. However, EGID preference is for proposals that provide both a pass-through model and a PMPM option.

3. Timing of an executed subcontractor agreement

References: Attachment B, Section 13.3; Bidder Instructions, Section 7.12; Attachment A, Sections 3.1.0.7 and 3.1.0.8.

Attachment B Section 13.3 states that a proposed subcontractor shall be identified by entity name in the applicable proposal, and that as part of the approval request the supplier shall provide a copy of a written agreement executed by the supplier and subcontractor.

a. Must a fully executed subcontract agreement with a proposed EGWP subcontractor be in place and submitted with the bid response on September 17, 2026?

Preferred but not required.

b. If not, at what point must the executed agreement be provided, with the approval request, at award, or prior to the subcontractor performing services?

A letter of intent or signed term sheet is sufficient, however, the name(s) of the entity(ies) providing the commitment(s) must be identified.

c. Is a letter of intent or signed term sheet sufficient at bid submission, provided the entity is identified by name and Exhibit 2 is completed?

A letter of intent or signed term sheet is sufficient, however, the name(s) of the entity(ies) providing the commitment (s) must be identified.

4. Timing and negotiability of insurance requirements

References: Attachment B, Section 8; Bidder Instructions, Section 7.3.5; Attachment A, Sections 5.5.29 and 5.5.30.

a. Bidder Instructions Section 7.3.5 requires the Certificate of Insurance in Section 3 of the bid. Attachment B Section 8 states the supplier may not commence performance until proof has been provided. Must the required limits be bound and evidenced as of the September 17, 2026 submission, or is it sufficient to evidence current coverage at submission and bind the required limits before the contract effective date of January 1, 2028?

It is sufficient to provide evidence of current coverage at submission and bind the required limits before the contract effective date. However, if you cannot meet the required limits at the time of proposal submission, please redline and take exception to Attachment B Section 8.

b. Attachment B Section 8 provides that the stated limits apply "unless agreed between the parties and approved by the state purchasing director." Will EGID consider a request to vary the minimum limits, and if so, should such a request be submitted as a requested exception in Section 5 of the bid or by another method?

If you cannot meet the required limits at the time of proposal submission, please redline and take exception to Attachment B Section 8.

c. Do the limits in Attachment A Section 5.5.30, comprehensive general liability, pharmacists professional liability, managed care liability, and errors and omissions, each at $5,000,000 per occurrence and in the aggregate, apply in addition to, or in place of, the limits in Attachment B Section 8?

Attachment B Section 8 provides the State of Oklahoma’s standard provision outlining bidder’s insurance requirements; however, Attachment A details EGID’s requirements for this particular contract. While there may be some overlap, EGID and the State of Oklahoma expect the responding bidders to comply with both provisions. Thus, Attachment A Section 5.5.30, $5,000,000 is in the aggregate of the limits in the Attachment B Section 8.

d. Does the same "unless agreed between the parties" provision extend to the limits in Attachment A Section 5.5.30 and to the fidelity and performance bond amounts in Attachment A Section 5.5.29?

Yes

5. SOC 1

References: Attachment A, Sections 3.1.0.3 and 5.29.17.

a. Section 3.1.0.3 requires the bidder's most recent SSAE 18 SOC 1 report. Section 5.29.17 separately requires the PBM to maintain SOC 2 Type 2 certification. Will a current SOC 2 Type 2 report satisfy the SOC 1 requirement in Section 3.1.0.3, or are both reports required?

Both reports included in 3.1.0.3 and 5.29.17 are required.

b. If both are required, may the SOC 1 requirement be satisfied by the SSAE 18 SOC 1 report of the claims processing platform the bidder will utilize, where that platform performs the transaction processing addressed by the report?

In the event that the PBM’s claims processing platform subcontractor is performing all applicable services under the contract, the PBM may satisfy both requirements by providing a SSAE18 SOC 1 Type 2 report from its claims processing platform. In the event that the PBM is performing any of these system and organization controls on its own, it will need to provide a separate SSAE18 SOC 1 Type 2 report.

6. Parent guarantee, indemnification, and personnel-naming timing

References: Attachment A, Sections 5.5.29, 5.5.31, 5.13.3, 5.22.1, and 5.22.2.

a. Section 5.5.29 states that if the bidder is a subsidiary of another corporation, the parent corporation shall additionally guarantee and indemnify the performance of the subsidiary. Is a parent guarantee a mandatory element of every bid submitted by a subsidiary, or may a subsidiary bidder satisfy Section 5.5.29 solely through its own fidelity bond, performance bond (or letters of credit in lieu thereof), and insurance, without a separate parent guarantee?

Yes, If the bidding PBM is a subsidiary of another corporation, per the requirement, the parent corporation shall additionally guarantee and indemnify the performance of the subsidiary.

b. Section 5.5.31 requires the PBM to indemnify and hold EGID harmless for PBM negligence or failure to perform, and states that EGID will provide no indemnity in favor of the PBM. Is this indemnification provision open to negotiation, and if so, should a bidder raise it as a requested exception in Section 5 of the bid rather than as a clarification question?

Bidder may respond to this requirement with “fully agree”, “partially agree”, or “disagree”. While the bidder may choose to “partially agree” or “disagree” with the provision and provide alternative language that it can accept, such a response may be taken into account when the State is evaluating the responsive bid.

c. Section 5.13.3 requests the name, tenure, experience, and account count of each member of the designated EGID account team (Account Director, Account Manager, Clinical Pharmacist, Executive Sponsor, Financial Analyst, Implementation Manager, IT Specialist, EGWP Account Manager, EGWP Specialist, Eligibility Specialist, and Communications Specialist). Must every one of these individuals be identified by name in the bid response submitted on September 17, 2026, or may a bidder identify each role along with its qualifications and experience level in the bid and supply the specific individual's name at a later point, such as after award or prior to implementation?

The bidder must identify each role as much as possible and may a bidder identify each role along with its qualifications and experience level in the bid and supply the specific individual's name at a later point. The bidder must identify why it was not able to identify those individuals by name. Also for that specific individual identified (or will be assigned) please include number of clients each individual is (will be) supporting.

d. Section 5.22.1 requests the name of the "point person" responsible for the timeliness and success of any EGID conversion/implementation, along with that individual's qualifications and a reference from a recently completed, similarly sized implementation. Must this individual be named in the bid, or may a bidder describe the qualifications and experience the point person will hold and provide the individual's name at a later point?

The bidder must identify each role as much as possible and may a bidder identify each role along with its qualifications and experience level in the bid and supply the specific individual's name at a later point. The bidder must identify why it was not able to identify those individuals by name. Also, if specific individual was identified (or will be assigned) please include number of clients each individual is (will be) supporting.

e. Section 5.22.2 requires the bidder to assign an Implementation Manager and asks whether that individual will be solely dedicated to the EGID implementation. Must this individual be named in the bid, or may a bidder describe the role's qualifications and dedication level in the bid and identify the specific individual at a later point?

The bidder must identify each role as much as possible and may a bidder identify each role along with its qualifications and experience level in the bid and supply the specific individual's name at a later point. The bidder must identify why it was not able to identify those individuals by name. Also, if specific individual was identified (or will be assigned) please include number of clients each individual is (will be) supporting.

7. Covered lives threshold at the claims platform level

References: Attachment A, Section 3.1.0.9.

a. Section 3.1.0.9 requires that the claims processing system and related operations utilized by the PBM currently have a minimum of 1,000,000 covered lives for which it provides commercial (non-Medicare Part D) PBM services. May this threshold be satisfied by the covered lives of the underlying claims processing platform the bidder will utilize, including a platform operated by a subcontractor or shared across multiple clients, rather than being limited to the bidder's own directly-contracted book of business?

Using the covered lives solely by using underlying claims processing platform the bidder utilizes, including a platform operated by a subcontractor or shared across multiple clients will not satisfy the requirement. However, the bidder may choose to still bid on the RFP. If so, the bidder must clearly demonstrate how the proposed solution currently meets the requirement and has sufficient capacity, operational capability and maturity, and scalability to accommodate the additional EGID workload. EGID reserves the right to determine whether the bidder’s response adequately demonstrates compliance and to deem a bidder non-responsive if it does not.

8. Following changes/edits are made to Attachment A Section 5. Specifications and Requirements of RFP

A)

5.2.51. "PBM Affiliates" of a party shall mean an entity:

(i) which is directly or indirectly, through one or more intermediaries, controlling such party;

(ii) which is under the same direct or indirect ownership or control as such party; or

(iii) which is directly or indirectly, through one or more intermediaries, owned or controlled by such party.

(iv) owned by PBM or its parent company(ies) and any entities that are directly or indirectly owned by any entity in the upstream ownership chain of PBM, including but not limited to the parent or any other owners of the parent.

For purposes of this definition and the Agreement, “control” (including the terms controlling, controlled by or under common control with) means (a) the possession, direct or indirect, (b) the power to direct or cause the direction of the management or policies of an entity, or (c) the ability to direct an entity’s affairs or to control the composition of its board of directors or equivalent body, whether through (i) 10% of more of voting securities, (ii) partnership or membership interests, (iii) by contract or (iii) any other means.

Further, a Group Purchasing Organization shall also be considered a PBM Affiliate to the extent the GPO meets the above definition.

B)

5.15.17. PBM, not EGID, will be responsible for maintaining this formulary at no additional cost to EGID.

9. Exhibit 10 is now included with Amendment 1

A) Section 5.29. “Additional OK Section 1330.1 of Title 74 (SB1447) Statutory Requirements section requires compliance with SB1447, bidders must acknowledge and agree to SB1147 statuary language by signing Exhibit 10 – SB1447 Bidder Certification. All bidders must “Fully Agree” to all the requirements in the section and provide required compliance narratives.

10.

After loading the data that was sent, it looks like the Commercial data file was truncated towards the end (example below):

Is this intended? If it is not, may I request a replacement file? The data ends abruptly which suggests that perhaps something when wrong during the creation of the file, and I want to be sure we have all information.

We have reviewed the files internally and the data posted on OneDrive site, and we do not see any issues with the data or files. It may be an issue/error with the bidder downloading it.

11. As the RFP states that the “initial term” will be for one year with an option to renew for 4 additional years. What year is the current PBM contract in, as it relates to the option to renew clause?

2026 is contract year 2. The state contract is renewed annually.

12. The RFP states that an award will be based on “Best Value”. Does this imply that Oklahoma Administrative Code § 610:1-11-7, is being applied to the award of the RFP.

No, “best value” refers to “Best Value Criteria” as defined and used in the Oklahoma Central Purchasing Act and Oklahoma Administrative Code Title 260 Chapter 115.

13. In article 3.1. Mandatory Requirements, Section 3.1.0.1 it states: “Bidder shall specifically document experience in commercial and EGWP PBM serves for a minimum of seven (7) years. Experience may include that of acquired companies, predecessor entities, or merged organizations, provided such operations, personnel, systems, and contractual capabilities are materially integrated into the bidder’s current operations.” Is the “7 year” criteria based upon a statutory requirement or is the 7 years arbitrary.

The seven-year experience requirement is not a statutory requirement. It is a minimum experience established by the EDIG to ensure the selected PBM has demonstrated experience in commercial and EGWP PBM services to successfully manage the size, duties, and EGID’s PBM expectations. The requirement is intended to provide the EGID with confidence that the PBM bidder has the operational qualification, systems, personnel, and capabilities to deliver the PBM services effectively and less risk.

3.1.0.1 Bidder shall specifically document experience in commercial and EGWP PBM serves for a minimum of seven (7) years. Experience may include that of acquired companies, predecessor entities, or merged organizations, provided such operations, personnel, systems, and contractual capabilities are materially integrated into the bidder’s current operations.

14. In article 3.1. Mandatory Requirements, Section 3.1.0.2 it states: “Bidder shall provide at least three (3) business references from non-affiliated clients that perform similar services as outlined in 7.11” Is the term “similar” defined as PBM, EGWP, or any combination that may or may not include both?

For business references, the vendors are highly recommended to provide combination of both PBM and EGWP. But it’s not mandatory to include both.

15. In article 3.1. Mandatory Requirements, Section 3.1.0.5 it states: “Bidder must provide a copy of its administrator's license issued by the Insurance Commissioner for the State of Oklahoma.” Must this license be in place prior to the award of the contract, or can it be obtained from the post award?

The license does not need to be in place at the time of bid submission. If the bidder reaches the final BAFO stage, it must initiate the licensing process and provide EGID proof that the application has been submitted. The license must be obtained before contract execution and before any services are performed under the contract including transition meetings. Failure to obtain the required license will disqualify the bidder from award.

16. In article 3.1. Mandatory Requirements, Section 3.1.0.1 it states a combined 7-year experience requirement; however, Section 3.1.0.6 and 3.1.0.8 have separate requirements for PBM and EGWP. Which requirement will supersede?

The requirements are cumulative and do not supersede one another. The bidder, or subcontract, must demonstrate a minimum of seven years of PBM experience, including a minimum of three years of EGWP experience. The three years of EGWP experience may be included within the bidder’s (or subtractor’s) overall seven years of PBM experience.

17. If an exception is to be requested, must it be in the Reply to the RFP or can be inquired about during the Question-and-Answer period.

It depends on the exception. If it is Attachment A 5.0 Section, the bidder has the opportunity to “Fully Agree,” “Partially Agree,” or “Disagree.” If your answer is not “Fully Agree,” you must provide a brief of your deviation in Exhibit #7 and also see the Section 5: Requested Exceptions to Terms section in the Bidder Instruction

18. Will an eligibility file be provided upon request.

No, not as part of the RFP.

19. Are Medicare eligible members under the age of 65 allowed to remain on the PBM contract? If yes, are they identified on an eligibility file?

Yes, they are allowed to remain on the plan. If the member is a former employee and EGID notified of their Medicare status, EGID works with the member to get them enrolled in a Medicare plan option. If EGID is unaware of their Medicare status, they remain on their non-Medicare plan option. EGID does not have an indicator on the eligibility file that indicates Medicare eligible and under 65. EGID enrolls them in the proper plan and send the eligibility data over on the file. Medicare under 65 can be a result of disability, it does not only apply to those with ESRD. People we identify as having ESRD are tracked internally. We place those members on a special plan when they are in their coordination period. The PBM takes the eligibility from EGID and that will drive their pharmacy plan.

20. Are Social Security eligible / disabled members allowed to remain on the PBM contract? If yes, are they identified on an eligibility file?

Yes, they are allowed to remain on the plan. No, there is not a special identifier on the file.

21. Are there any Medicare eligible members over the age of 65 who have opted not to join the Employer Group Waiver Plan [EGWP] and have remained on the PBM coverage?

Active employees that are 65 or older would not be placed in an EGWP plan. Those plans are only available to former employees.

22. Please confirm the State will accept a NADAC-based proposal in lieu of providing guaranteed discount and dispensing fees. If so, Bidder will provide illustrative guarantees for Vendor comparison purposes.

In this procurement cycle, EGID elected to use transparent and PMPM pricing models.

23. Attachment A, 3.1.0 states: “Bidders shall comply with all requirements in this section and provide proper documentation in their response to meet each Mandatory Requirement.” Please provide additional guidance clarifying what proper documentation is required in Bidders’ response to Section 3.1.

Bidders should provide narrative and documentation sufficient to demonstrate compliance with each Mandatory Requirement in Section 3.1. This may include organizational information, and other supporting information and experience requested to substantiate the bidder’s response to each requirement.

24. Attachment A, 4.0.0 includes the following language: “or loaded with errors and indicate the specific data that failed to load and the reason for the incomplete, partially loaded, or errored data record.” Please confirm the above language within this provision was included in error.

Confirmed. That section should be removed from the 4.0.0.

25. Bidder is developing comprehensive EGWP services, which will be operational 1/1/2027. Bidder requests that the requirement that vendors have seven (7) years of EGWP experience be modified or removed (Requirement 3.1.0.1).

PBM’s, or subcontractors, of the EGWP product must be in operations with clients actively participating in its EGWP product for the past three (3) years.

26. Bidder is developing comprehensive EGWP services, which will be operational 1/1/2027. Bidder requests that the requirement that PBMs or subcontractors of the EGWP product be operational for the past three (3) years be modified or removed (Requirement 3.1.0.8).

PBM’s, or subcontractors, of the EGWP product must be in operations with clients actively participating in its EGWP product for the past three (3) years.

27. Is the State requesting Bidders submit redacted copies of proposals or is the intent of Section 7.4, contained within the Agency Bidder Instructions only for Vendors to designate applicable portions of their proposals proprietary and confidential?

Nothing in the bid is confidential, even if marked proprietary and confidential, unless confidentiality is granted by the State Purchasing Director (SPD). One notable exception is certain financial data used to qualify the bidder. The intent is that the bidders request certain sections or portions to be held confidential, if the SPD grants that request, then EGID will have access to that information, EGID will use that information in awarding the contract and the State EGID will have access to that information in administering the contract. However, if anyone else requests a copy of the contract or contract documents, it will be redacted at that point. As a practice, after award, the State creates an unredacted version of the contract to be used in contract administration and a redacted version as the "public" version of the contract.

28. Does the State maintain or operate any in-house pharmacies? If so, Bidder requests additional information such pharmacies.

No, EGID does not maintain or operation any in-house pharmacies.

29. Please describe the State’s coverage strategy for GLP-1s, including whether or not the State covers GLP-1s for weight loss, diabetes, and/or other indications.

For the commercial population, EGID currently covers GLP-1s diabetes indication only For the EGWP population, EGID currently covers all Medicare approved indications except weight loss.

30. Why is the State procuring PBM services at this time?

EGID is conducting the procurement to secure PBM services that meets the State’s future needs. It provides an opportunity to evaluate available pricing options, service models, various PBM capabilities, and favorable contractual terms and to make sure that the State continues to receive cost-effective PBM services for its members.

31. What is working well with the State’s current PBM and what could be improved through the potential replacement?

EGID’s current PBM provides the required services. This procurement gives EGID an opportunity to evaluate the current marketplace and find opportunities to improve overall value, transparency, account management services, clinical programs, member experience, and technology etc. EGID is seeking bidders that will show opportunities to enhance the overall PBM program.

32. When will historical claims files and other data be received by Bidders?

The claims files are available to bidders as soon as the bidders sign and submit NDAs.

33. The data received does not contain formulary tiers/status indicators, without which formulary disruptions cannot be created. May we request data that has the indicators, or let us know how to best move forward.

See Exhibit 5 – Formulary & Network Disruption

34. Please confirm that Attachment A is applicable to EGWP only.

No. Attachment A does not apply exclusively to EGWP. Unless a specific section of Attachment A is expressly designated as applying to EGWP or Commercial, the requirements apply to both lines of business.

35. Please confirm what lines of business Attachment B ("General Terms") is applicable.

Attachment B applies to both Commercial and EGWP lines of businesses

36. Per 7.5.1 of the Bidders Instructions, "Any requested exception or revision to terms or conditions provided by the State of Oklahoma shall be redlined in Word format using track changes. If no exceptions or revisions are requested, the bid should reflect that by inserting a page to denote this section is not applicable”

a. In lieu of a redlined and track changes document for Attachments A-D, may bidders instead respond with "Bidder Response: XXX" that allows us to address each item individually?

No. The bidder must redline the attachment.

37. Per 5.11.34: Please confirm if EGID plans on having a custom formulary, or customizing a standard formulary.

Currently, EGID uses PBM’s standard Medicare formulary. The bidder should provide its standard Medicare formulary, along with the associated costs and benefits of developing a custom Medicare formulary for EGID to comply with SB 1447 (see 5.29.4).

38. Per 5.23.10 & 5.25.22: These two items seem to contradict each other. Can you confirm that the offer should be for a 1 year term, effective 1/1/2028, with four 1 year extension options?

(EGWP Only) Given the material impact that Federal price negotiations have had, and are expected to continue to have, on the economics of products subject to Maximum Fair Price (MFP) provisions, please confirm that 2026 and 2027 MFP-designated drugs should be excluded from both Discount and rebate guarantees, with such claims adjudicated at a pass-through of CMS-contracted rates, and with any supplemental rebates earned on these products fully passed through to Oklahoma.

The State contract terms are one year contract with an option to renew for 4 additional years.

39. General: How many rounds will be conducted during the Reverse Auction and through what tool will it be conducted?

EGID reserves the right, at its sole discretion, to conduct one or more Best and Final Offer rounds, including reverse auction events, as part of the evaluation process. During these rounds, bidders may be provided with limited information regarding their relative ranking or competitive position based on EGID's evaluation of cost, technical, operational, contractual, and other solicitation criteria. EGID may determine the type, timing, tool, and extent of any information shared with bidders.

40. General: Do the terms and conditions in the initial submission supersede any resulting rounds as we move into the reverse auction?

EGID reserves the right, at its sole discretion, to conduct one or more Best and Final Offer rounds, including reverse auction events, as part of the evaluation process. During these rounds, bidders may be provided with limited information regarding their relative ranking or competitive position based on EGID's evaluation of cost, technical, operational, contractual, and other solicitation criteria. EGID may determine the type, timing, tool, and extent of any information shared with bidders.

Following any BAFO or reverse auction round, EGID may, at its sole discretion, eliminate one or more bidders from further consideration, including the lowest-ranked bidder(s), or elect to retain all bidders and conduct additional rounds. Participation in any BAFO round, receipt of ranking information, or advancement to subsequent rounds does not guarantee continued consideration, contract negotiations, or award. All evaluation and selection decisions shall remain solely within EGID’s discretion.

41. General: Related to your EGWP formulary, how many tiers are on the formulary?

EGID uses current PBM’s standard Medicare formulary. There are 4 tiers.

Cost-Sharing Tier 1: Generic Cost-Sharing Tier 2: Preferred Brand Cost-Sharing Tier 3: Non-Preferred Brand Cost-Sharing Tier 4: Specialty (High Cost)

Copies of the EGID formularies are available on our website, https://oklahoma.gov/healthchoice.html under Active for Commercial and Medicare for EGWP

42. General: Does EGID have its own specialty drug list? If so, can you please provide by NDC?

EGID does not own a specialty drug list, however, see answer to Questions to 57.

43: General: May bidders submit less than four formulary options?

Yes

44. General: Please provide monthly volume of member calls handled by the call center.

Follow are PBM CSR calls

45. General: Please provide the average number of prior authorizations, appeals, and grievances per month (or annually).

· Commercial – 2025 annual

· PAs: 32,298 (1,742 Admin, 30,556 Clinical)

· Appeals:

· 1st Level – 1,091

· 2nd Level – None

· 3rd Level – None

· Admin – 102

· External - 6

· Grievances: 3

· DMRs: 904

· EGWP – 2025 annual

· PAs: 3,269 (473 Admin, 2,796 Clinical)

· Appeals:

· 1st Level – 744

· 2nd Level – 34

· 3rd Level - 3

· Grievances: Not Provided

· DMRs: 33 (17 EGWP, 16 WRAP)

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

· Commercial – 2025 annual

· DMRs: 904

· EGWP – 2025 annual

· DMRs: 33 (17 EGWP, 16 WRAP)

47. General: As a privately held company, ‘company X’ 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 us to submit the requested documents.

The contracting officer listed on the Bidder Instructions will receive the audited statements from the Supplier Portal’s bid line factor for financial statements. The bidder should submit to the contracting officer through the Supplier Portal’s bidder questions.

48. Attachment _C_EGID _Agency Terms : In Section C.1 Definitions (3); “Contract” shall be defined as specified below in Section B of this Attachment. Please clarify where Section B is located.

Please see the definition of "Contract" as: “the written, mutually agreed and binding legal relationship resulting from the contract documents and an appropriate encumbering document as may be amended from time to time, which evidences the final agreement between the parties with respect to the subject matter of the contract.”

For Section B see above definition.

49. Attachment A, Payment Terms: 5.7.3 Currently, how many business days does it take to pay claim invoices?

EGID is seeking PBM to allow EGID 14 business days to pay claim invoices. Respondent shall indicate “Fully Agree,” “Partially Agree,” or “Disagree.” If your answer is not “Fully Agree,” you must provide a brief of your deviation in Exhibit #7.

5.7.3. PBM shall allow EGID 14 business days to pay claim invoices.

50. Attachment A, 5.25 Pricing Requirements, 5.25.22: What is the average monthly claim volume of compounded prescriptions with greater than $200 charges?

For the Commercial plan, there were 2 compound claims in 2025 over $200.

For the EGWP plan, there were 213 compound claims in 2025 over $200.

51. Attachment A 5.2.7 Please provide examples of a Brand Drug or Brand Product with the following MONY codes: Brand Name code of “B” or “T” and Multisource Code of “N” and DAW not equal to 5 Brand Name code of “B” or “T” and Multisource Co de “O” and a DAW code of 0, 1, 2, 7, 8, or

DAW information is provided in the claims files and Brand Name code and Multisource Code can be sourced via Medispan.

52. Attachment A 5.2.32 What is the rationale for specifying the number of pharmacies in the following definition: 5.2.32: "Limited Distribution Specialty Drugs" are those Specialty Drugs only available through limited pharmacy providers (15 or less) as determined by the drug manufacturer.

To provide consistency in bidding process and eventual evaluation.

53. Pricing Is it the preference of EGID to either have pricing guarantees (for example AWP - discounts) or an all-inclusive per PMPM guarantee?

EGID preference is for proposals that provide both a pass-through model (pricing guarantee) and a PMPM option. Both must have financial, performance, and service guarantees.

54. Agency Bidder Instructions, Due Dates

Please clarify the EGID’s committed date to respond to bidder questions. Considering the detailed nature of this RFP and the need for bidders to have sufficient time to respond to the full RFP based on EGID’s response to bidder questions, please confirm that EGID will allow bidders a minimum of 10 business days from the date in which it responds to all bidder questions to finalize their proposal.

The answers to questions will be posted more than 10 business days before the RFP due date of Sep 17, 2026.

55. Agency Bidder Instructions

1. In review of the RFP materials, we did not identify any specific scoring tables, indication of points to be awarded by section or portion of the RFP, nor any specific weighting or other evaluation criteria. Please share any specific evaluation criteria, the evaluation process, and scoring / points EGID has associated with each component of a bidder’s response.

1. As noted in the Bidder’s Conference, we understand that EGID intends to evaluate the Financial Proposal and Clinical Fees separately. Please provide additional details on the specific weighting given to the Financial Proposal and Clinical Fees.

The Solicitation Criterion is listed on Attachment A.2.

EGID reserves the right, at its sole discretion, to conduct one or more Best and Final Offer rounds (BAFO), including reverse auction events, as part of the evaluation process. During these rounds, bidders may be provided with limited information regarding their relative ranking or competitive position based on EGID's evaluation of cost, technical, operational, contractual, and other solicitation criteria. EGID may determine the type, timing, tool, and extent of any information shared with bidders.

Following any BAFO or reverse auction round, EGID may, at its sole discretion, eliminate one or more bidders from further consideration, including the lowest-ranked bidder(s), or elect to retain all bidders and conduct additional rounds. Participation in any BAFO round, receipt of ranking information, or advancement to subsequent rounds does not guarantee continued consideration, contract negotiations, or award. All evaluation and selection decisions shall remain solely within EGID’s discretion.

Proposals submitted in response to this RFP shall adhere to all requirements outlined in subsequent sections, including the completion and submission of all required forms and certifications. The submissions will be reviewed and scored in accordance with the evaluation methodology and criteria. Contract awards will be made based on the best overall value determination, considering both technical merit and pricing.

EGID reserves the right to evaluate proposals in accordance with the requirements and provisions of the RFP and to consider the overall responsiveness, qualifications, capabilities, pricing, and value offered by each bidder. 74 O.S. 85.2 provides a non-exhaustive list of examples of evaluation criteria that may be used in a Best Value Criteria RFP.

56. Exhibit 3 Financial Questionnaire and Price Sheet, Overview Tab & Attachment A, Requirement 5.2.63

The overview tab of Exhibit 3 Financial Questionnaire notes that PCSK9 products are considered Specialty. Please confirm whether PCSK9 products are considered Specialty products currently.

Typically, PCSK9 products are considered non-Specialty products in the marketplace, and upon reviewing the definition of a “Specialty Drug” from 5.2.63 in Attachment A, PCSK9 products may not generally meet this definition.

For the bid, PCSK9 claims are NOT considered specialty. They were moved to retail a few years ago but they started off as specialty.

57. Attachment A, Requirement 5.2.63

Regarding question 5.2.63 of Attachment A, we are not aware that SB 1447 provided a specific definition of “Specialty Drugs”. Please clarify whether SB1447 defines “Specialty Drugs” as suggested in 5.2.63 or if Bidders should understand that the definition of “Specialty Drugs” in 5.2.63 is EGID’s requested definition.

The definition in 5.2.63 of Attachment A is specific to the EGID bid process and should be adhered to accordingly. There is not a specific Specialty Definition in SB 1447, this only identifies the requirements tied to specialty-designated products.

58. Exhibit 3 Financial Questionnaire and Price Sheet, Overview Tab

Please describe any additional formulary, plan design, or UM strategies for preferred products that might not otherwise be identifiable in the information provided.

Please provide applicable formulary, plan design and UM edits as you see fit based on the EGID-specific data provided as part of the bid process. Vendors will be evaluated on their bids provided. Latitudes provided on the basis of clinical edits will be reviewed and accounted for as applicable between each bid.

59. Exhibit 3 Financial Questionnaire and Price Sheet, Overview Tab & RX-Pricing, MFP Comm Tab

To the extent that a bidder does not have four different exclusionary formularies, please confirm that bidder may elect to provide less than four rebate/formulary options for EGID’s consideration.

Yes

60. Exhibit 3 Financial Questionnaire – Price Sheet, Rx-Pricing, Exclusions EGWP (Discount & Dispensing Fee Guarantee Exclusions)

Understanding that exclusions tables have provided a line item for bidders to respond for Maximum Fair Price Drugs (MFP) by year, and given the material impact that Federal price negotiations has had and is expected to continue to have on the value of products subject to Maximum Fair Price (MFP) negotiations, please confirm bidders can exclude the 2026, 2027, and 2028 MFP drugs from Discount guarantees, with the understanding that they will process at a pass through of CMS contracted rates?

Whether or not the noted drugs (by year) are included or excluded in the proposed financial guarantees is ultimately up to the bidder. Depending on how your offer is underwritten, please accurately choose whether these will be included or excluded from the applicable financial guarantees based on the year the MFP pricing goes in place and which population for EGID.

Please also confirm that EGID will work in good faith to address any pricing changes as a result of further negotiations by CMS for both pricing and rebates for any future Maximum Fair Price (MFP) drugs, i.e. those to be announced for 2029 and beyond.

Yes, the expectation would be that EGID and their chosen PBM would work in good faith to ensure all entities involved will only make changes that lead to each party being no better or worse than previous.

61. Exhibit 3 Financial Questionnaire – Price Sheet, Rx-Pricing, Exclusions EGWP (Manufacturer Payment Guarantee Exclusions)

For the EGWP, given the material impact that Federal price negotiations has had, and is expected to continue to have, on the rebate value of products subject to Maximum Fair Price (MFP) negotiations, please confirm bidders can exclude the 2026, 2027, and 2028 MFP drugs from rebate guarantees, with the understanding that any supplemental rebates earned would still be passed through.

Whether or not the noted drugs (by year) are included or excluded in the proposed financial guarantees is ultimately up to the bidder. Depending on how your offer is underwritten, please accurately choose whether these will be included or excluded from the applicable financial guarantees based on the year the MFP pricing goes in place and which population for EGID.

Please also confirm that EGID will work in good faith to address any pricing changes as a result of further negotiations by CMS for both pricing and rebates for any future Maximum Fair Price (MFP) drugs, i.e. those to be announced for 2029 and beyond.

Yes, the expectation would be that EGID and their chosen PBM would work in good faith to ensure all entities involved will only make changes that lead to each party being no better or worse than previous.

62. Exhibit A, Requirement 5.14.16

Please share details of EGID’s current biosimilar strategy. Please also share any planned changes or future strategy requests specific to biosimilars.

EGID expects the selected PBM to bring innovative, proven, clinically and cost-effective strategies for the use of biosimilars, including recommendations and concrete steps to maximize savings and overall value while maintaining appropriate member access and quality of care. The bidders must demonstrate how they have successfully collaborated with providers to adapt the appropriate utilization of biosimilar agents.

5.14.16. Describe what programs your organization has in-place to assist members and plan sponsors in identifying the lowest cost of specific generic, brand, specialty and biosimilar drugs and in particular where the lowest drug cost may be outside of your existing network (e.g. a cost-plus mail-order pharmacy).

63. Attachment A, Requirement 5.29.16

In Attachment A, requirement 5.29.16 states Any guarantees established by the contract between a PBM and EGID shall be determined by total net cost and access outcomes and shall not be determined by rebate volume. Such performance guarantees shall include clear remedies in the form of credits payable by the plan for failure to comply with the provisions of the contract.

1. Please confirm the intent of 5.29.16 is to seek bidder’s confirmation that it will comply with SB 1447, which also further states that total net cost will be calculated "without regard to gross rebate volume or the list price of the drug."

The intent of #5.29.16 is to ensure that bidder proposals are based off of utilization specific to EGID vs. bidder’s overall book-of-business, including total rebate volume. The goal of this process is for EGID to move forward with a Transparent & Pass Through pricing arrangement specific to their own Rx utilization vs. having the ability to offset guarantees from other financial channels or book-of-business utilization.

1. Please also provide EGID’s interpretation and definition of “total net cost” as well as any specific guidance regarding how Bidders should propose guarantees related to “total net cost” in Exhibit 3 Financial Questionnaire Price Sheet.

Total Net Cost is expected to equal total drug cost + any applicable fees (administrative, dispensing, clinical, etc.) – calculated minimum rebate guarantees.

64. Financial Questionnaire and Price Sheet, RX-Pricing, Disc & DF Comm Tab

Please advise if EGID’s interpretation is that a pricing offer based upon Brand and Generic Effective Rate Guarantees (which are required on the RX-Pricing, Disc & DF Comm tab of Exhibit 3 Financial Questionnaire Price Sheet) would be compliant under SB 1447 (which requires Total net cost to be " the sum of all amounts paid by the state plan for covered prescription drugs including, but not limited to, all ingredient cost amounts, dispensing fees, and any other amounts billed to the state plan and all amounts paid by covered members for covered prescription drugs, including co-payments, coinsurance, and deductible amounts, minus all rebates and remuneration required to be passed through to the state plan.), as well as requirement 5.29.16 (which requires that Any guarantees established by the contract between a PBM and EGID shall be determined by total net cost and access outcomes and shall not be determined by rebate volume. Such performance guarantees shall include clear remedies in the form of credits payable by the plan for failure to comply with the provisions of the contract.)

Yes as EGID is requesting a Transparent & Pass Through pricing and/or all-in PMPM pricing proposal. This language essentially states that Traditional pricing or any retention of Rx costs between what the PBM pays and what EGID pays will not be permitted.

If EGID’s interpretation is that a Brand and Generic Effective Rate Guarantee arrangement would not be compliant under SB 1447, please provide guidance for Bidders as to how to present their financial offer within this RFP. To the extent there is variance by Retail, Mail, or Specialty channels, please address each separately.

See above response.

65. Financial Questionnaire and Price Sheet, RX-Pricing, MFP Tabs

Related to SB 1447 and requirement 5.29.16, which required that “total net cost” not be determined by rebate volume, please advise whether EGID’s interpretation is that Guaranteed Manufacturer Payment Amount Minimums, set as a Per Member Per Month (PMPM) or Per Brand Claim amount as required in the RX-Pricing, MFP tabs of Exhibit 3 Financial Questionnaire Price Sheet, would be compliant under SB 1447 and “total net cost” as required in question 5.29.16 of Attachment A.

Yes as EGID is requesting a Transparent & Pass Through pricing and/or all-in PMPM pricing proposal. The request here is that there would be no offsetting across financial guarantees but also, specific to rebates, that 100% of all rebates and applicable dollars received as a result of EGID’s utilization would ultimately flow through to EGID and not be retained in any part by bidder or bidder affiliate (e.g., rebate aggregator or GPO).

If such rebate guarantees would not be compliant under SB 1447 and “total net cost”, please provide guidance for Bidders as to how to present their financial offer within this RFP.

See above response.

66. Attachment A, Requirement 5.2.63

Please clarify whether SB1447 defines “Specialty Drugs” as suggested in 5.2.63 or if Bidders should understand that the definition of “Specialty Drugs” in 5.2.63 is EGID’s requested definition. We are unable to identify the specific definition of “Specialty Drugs” noted in 5.2.63 or any other specific definition of “Specialty Drugs” in the available SB 1447 text.

The definition in 5.2.63 of Attachment A is specific to the EGID bid process and should be adhered to accordingly. There is not a specific Specialty Definition in SB 1447, this only identifies the requirements tied to specialty-designated products.

67. Agency Bidder Instructions, 7.4 Section 4: Bid Portions Requested to be Held Confidential

1. Please confirm the definition of Price as it relates to Section 7.4.5 of Agency Submitted Bidder Instructions, which states:

While bidder agrees that total contract price would not be a trade secret or redacted, we would expect the individual price guarantees and values (discount or dispensing fee guarantees, administrative fee guarantees, rebate guarantees, PMPM guarantees, performance guarantees, client credits, etc.) throughout the RFP to remain confidential and trade secret.

No pricing information, including individual price guarantees and values (discount or dispensing fee guarantees, administrative fee guarantees, rebate guarantees, PMPM guarantees, performance guarantees, client credits, etc.) will be held confidential.

If Price is to be inclusive of individual price and values (discount or dispensing fee guarantees, administrative fee guarantees, rebate guarantees, performance guarantees, client credits, etc.), please specify any specific provisions(s) in Oklahoma State law prevent individual price and values redactions.

1. Please specify any specific provision(s) of Oklahoma Law that would prevent a bidder from redacting References (client reference information) as stated within Section 7.4.5 of Agency Submitted Bidder Instructions, which states:

As a client courtesy and because clients provided as references would not be parties to the resultant Agreement from this RFP, bidders may typically redact the references to protect the provided references’ confidentiality.

The Bidder Instructions per Section 7.4.5 states that certain items will never be deemed confidential under the Oklahoma Open Records Act.

Nothing would prevent a bidder from redacting References.