RFP 2025-0200-0177 02-101-25 PBM Services.pdf

STATE OF ALASKA

REQUEST FOR PROPOSALS

OFFERORS ARE NOT REQUIRED TO RETURN THIS FORM.

IMPORTANT NOTICE: IF YOU RECEIVED THIS SOLICITATION FROM THE STATE OF ALASKA’S “ONLINE PUBLIC

NOTICE” WEB SITE, YOU MUST REGISTER WITH THE PROCUREMENT OFFICER LISTED IN THIS DOCUMENT TO

RECEIVE NOTIFICATION OF SUBSEQUENT AMENDMENTS. FAILURE TO CONTACT THE PROCUREMENT OFFICER MAY

RESULT IN THE REJECTION OF YOUR OFFER.

ISSUED BY:

DEPARTMENT OF ADMINISTRATION

OFFICE OF PROCUREMENT AND PROPERTY

MANAGEMENT

PRIMARY CONTACT:

LISA TROMBI

PROCUREMENT SPECIALIST

DOA.OPPM.PROCUREMENT@ALASKA.GOV

PHARMACY BENEFIT MANAGER SERVICES

RFP 2025-0200-0177 / 02-101-25

ISSUED OCTOBER 16, 2025

THE DEPARTMENT OF ADMINISTRATION, DIVISION OF RETIREMENT AND BENEFITS,

IS SOLICITING PROPOSALS FOR PHARMACY BENEFIT MANAGER SERVICES

TO ASSIST IN THE ADMINISTRATION OF THE ALASKACARE HEALTH PLANS

mailto:doa.oppm.procurement@alaska.gov

STATE OF ALASKA – REQUEST FOR PROPOSALS RFP 2025-0200-0177 / 02-101-25

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TABLE OF CONTENTS

SECTION 1. INTRODUCTION & INSTRUCTIONS

SEC. 1.01 PURPOSE OF THE RFP

SEC. 1.02 BUDGET

SEC. 1.03 DEADLINE FOR RECEIPT OF PROPOSALS

SEC. 1.04 MANDATORY PRIOR EXPERIENCE

SEC. 1.05 DESIRABLE EXPERIENCE

SEC. 1.06 REQUIRED REVIEW

SEC. 1.07 QUESTIONS PRIOR TO DEADLINE FOR RECEIPT OF PROPOSALS

SEC. 1.08 RETURN INSTRUCTIONS

SEC. 1.09 ASSISTANCE TO OFFERORS WITH A DISABILITY

SEC. 1.10 AMENDMENTS TO PROPOSALS

SEC. 1.11 AMENDMENTS TO THE RFP

SEC. 1.12 RFP SCHEDULE

SEC. 1.13 PRE-PROPOSAL TELECONFERENCE

SEC. 1.14 ALTERNATE PROPOSALS

SEC. 1.15 NEWS RELEASES

SECTION 2. BACKGROUND INFORMATION

SEC. 2.01 BACKGROUND INFORMATION

SEC. 2.02 ABOUT ALASKACARE

SEC. 2.03 CURRENT PLAN DEFINITIONS

SEC. 2.04 CURRENT PLAN FEATURES AND COVERAGE

SEC. 2.05 CURRENT FINANCIAL CONTRACT AND STRUCTURE

SEC. 2.06 HISTORICAL FACTS AND FIGURES

SEC. 2.07 UNIQUE CONSIDERATIONS

SECTION 3. SCOPE OF WORK & CONTRACT INFORMATION

SEC. 3.01 SCOPE OF WORK

SEC. 3.02 CONTRACT TERM AND WORK SCHEDULE

SEC. 3.03 PBM DELIVERABLES

SEC. 3.04 MANDATORY REQUIREMENTS

SEC. 3.05 CONTRACTUAL REQUIREMENTS

SEC. 3.06 FINANCIAL REQUIREMENTS

SEC. 3.07 CONTRACT TYPE

SEC. 3.08 PROPOSED PAYMENT PROCEDURES

SEC. 3.09 CONTRACT PAYMENT

SEC. 3.10 ELECTRONIC PAYMENTS

SEC. 3.11 LOCATION OF WORK

SEC. 3.12 SUBCONTRACTORS

SEC. 3.13 JOINT VENTURES

SEC. 3.14 RIGHT TO INSPECT PLACE OF BUSINESS

SEC. 3.15 CONTRACT PERSONNEL

SEC. 3.16 INSPECTION & MODIFICATION - REIMBURSEMENT FOR UNACCEPTABLE DELIVERABLES

SEC. 3.17 CONTRACT CHANGES - UNANTICIPATED AMENDMENTS

SEC. 3.18 NONDISCLOSURE AND CONFIDENTIALITY

SEC. 3.19 INDEMNIFICATION

SEC. 3.20 INSURANCE REQUIREMENTS

SEC. 3.21 TERMINATION FOR DEFAULT

SECTION 4. PROPOSAL FORMAT AND CONTENT

SEC. 4.01 RFP SUBMITTAL FORMS

SEC. 4.02 SPECIAL FORMATTING REQUIREMENTS

SEC. 4.03 OFFEROR INFORMATION AND CERTIFICATIONS (SUBMITTAL FORM A)

SEC. 4.04 PRIOR EXPERIENCE (SUBMITTAL FORM B)

SEC. 4.05 SERVICE APPROACH (SUBMITTAL FORM C)

SEC. 4.06 RISK ASSESSMENT (SUBMITTAL FORM D)

SEC. 4.07 VALUE OPPORTUNITY ASSESSMENT (SUBMITTAL FORM E)

SEC. 4.08 MANDATORY REQUIREMENTS (SUBMITTAL FORM F)

SEC. 4.09 CONTRACTUAL REQUIREMENTS (SUBMITTAL FORM G)

SEC. 4.10 GEOACCESS ANALYSIS (SUBMITTAL FORM H)

SEC. 4.11 NETWORK DISRUPTION ANALYSIS (SUBMITTAL FORM I)

SEC. 4.12 FORMULARY DISRUPTION ANALYSIS (SUBMITTAL FORM J)

SEC. 4.13 SUBCONTRACTORS (SUBMITTAL FORM K)

SEC. 4.14 INTERVIEWS

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SEC. 4.15 COST PROPOSAL (SUBMITTAL FORM L)

SEC. 4.16 FINANCIAL REQUIREMENTS (SUBMITTAL FORM M)

SECTION 5. EVALUATION CRITERIA AND CONTRACTOR SELECTION

SEC. 5.01 SUMMARY OF EVALUATION PROCESS

SEC. 5.02 EVALUATION CRITERIA

SEC. 5.03 SCORING METHOD AND CALCULATION

SEC. 5.04 PRIOR EXPERIENCE

SEC. 5.05 SERVICE APPROACH

SEC. 5.06 RISK ASSESSMENT

SEC. 5.07 VALUE OPPORTUNITY ASSESSMENT

SEC. 5.08 CONTRACTUAL REQUIREMENTS

SEC. 5.09 NETWORK DISRUPTION ANALYSIS

SEC. 5.10 FORMULARY DISRUPTION ANALYSIS

SEC. 5.11 FINANCIAL REQUIREMENTS

SEC. 5.12 INTERVIEWS

SEC. 5.13 CONTRACT COST (COST PROPOSAL)

SEC. 5.14 ALASKA OFFEROR PREFERENCE

SECTION 6. GENERAL PROCESS AND LEGAL INFORMATION

SEC. 6.01 INFORMAL DEBRIEFING

SEC. 6.02 ALASKA BUSINESS LICENSE AND OTHER REQUIRED LICENSES

SEC. 6.03 SITE INSPECTION

SEC. 6.04 CLARIFICATION OF OFFERS

SEC. 6.05 DISCUSSIONS WITH OFFERORS

SEC. 6.06 EVALUATION OF PROPOSALS

SEC. 6.07 CLARIFICATION PERIOD

SEC. 6.08 CONTRACT NEGOTIATION

SEC. 6.09 FAILURE TO NEGOTIATE OR CLARIFY

SEC. 6.10 OFFEROR NOTIFICATION OF SELECTION

SEC. 6.11 PROTEST

SEC. 6.12 APPLICATION OF PREFERENCES

SEC. 6.13 ALASKA BIDDER PREFERENCE

SEC. 6.14 ALASKA VETERAN PREFERENCE

SEC. 6.15 ALASKA MILITARY SKILLS PROGRAM PREFERENCE

SEC. 6.16 STANDARD CONTRACT PROVISIONS

SEC. 6.17 QUALIFIED OFFERORS

SEC. 6.18 PROPOSAL AS PART OF THE CONTRACT

SEC. 6.19 ADDITIONAL TERMS AND CONDITIONS

SEC. 6.20 HUMAN TRAFFICKING

SEC. 6.21 RIGHT OF REJECTION

SEC. 6.22 STATE NOT RESPONSIBLE FOR PREPARATION COSTS

SEC. 6.23 DISCLOSURE OF PROPOSAL CONTENTS

SEC. 6.24 ASSIGNMENT

SEC. 6.25 FORCE MAJEURE (IMPOSSIBILITY TO PERFORM)

SEC. 6.26 DISPUTES

SEC. 6.27 SEVERABILITY

SEC. 6.28 SUPPLEMENTAL TERMS AND CONDITIONS

SEC. 6.29 SOLICITATION ADVERTISING

SEC. 6.30 FEDERALLY IMPOSED TARIFFS

SECTION 7. ATTACHMENTS

SEC. 7.01 ATTACHMENTS

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SECTION 1. INTRODUCTION & INSTRUCTIONS

SEC. 1.01 PURPOSE OF THE RFP

The Department of Administration, Division of Retirement and Benefits, is soliciting proposals from qualified and experienced firms to provide Pharmacy Benefit Manager (PBM) services to the State of Alaska’s AlaskaCare health plans.

SEC. 1.02 BUDGET

Department of Administration, Division of Retirement and Benefits estimates a budget of between $65,000,000.00 and $85,000,000.00 for completion of this project. Proposals priced at more than $100,000,000.00 will be considered non-responsive.

Payment for the contract is subject to funds already appropriated and identified.

SEC. 1.03 DEADLINE FOR RECEIPT OF PROPOSALS

Proposals must be received no later than 11:00 AM Alaska Time on December 15, 2025, as indicated by email timestamp. Proposals received after this deadline will not be considered.

SEC. 1.04 MANDATORY PRIOR EXPERIENCE

In order for offers to be considered responsive, offerors must meet these minimum prior experience requirements:

The offeror must clearly identify the Account Manager’s experience on Submittal Form B Prior Experience. The offeror’s firm must have experience in the same scope of work as required in this RFP and must include three Client Reference Forms, as provided as an attachment to this RFP, for whom you provide, or have provided, the same services as required in this RFP.

The offeror must clearly confirm they are not restricted or prohibited from conducting business in all states where AlaskaCare members reside or access care. The Client Claims Data Records file, detailed in Section 3.18, will indicate the states in which members live.

The offeror’s proposal must clearly demonstrate this experience, currently or within the last five years, including:

1. Offeror’s firm must have at least three years of experience in providing prescription drug benefit plan services under contract to at least five plan sponsors, each with a minimum of 5,000 covered lives, for a minimum duration of three years continuously. At least one of which plans must be a state or public sector client. If expired, the contract must have expired within the previous five years.

An offeror's failure to meet these minimum prior experience requirements shall cause their proposal to be considered non-responsive and rejected.

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SEC. 1.05 DESIRABLE EXPERIENCE

While it is not mandatory, offerors may choose to include or omit the following information at their discretion:

1. At least three years of experience in providing enhanced Employer Group Waiver Plan (EGWP) services.

2. Be contracted directly with the Centers for Medicare and Medicaid Services (CMS) for EGWP services.

3. Subcontractors may be used to provide any enhanced EGWP services to the State; however, any relationship must be disclosed to the State.

This experience is not a mandatory requirement and will not be evaluated or included in the proposal review to determine responsiveness. This information is requested for informational and planning purposes only.

SEC. 1.06 REQUIRED REVIEW

Offerors should carefully review this solicitation for defects and questionable or objectionable material.

Comments concerning defects and questionable or objectionable material should be made in writing and received by the procurement officer at least ten days before the deadline for receipt of proposals.

This will allow time for the issuance of any necessary amendments. It will also help prevent the opening of a defective proposal and exposure of the offeror’s proposals upon which award could not be made.

SEC. 1.07 QUESTIONS PRIOR TO DEADLINE FOR RECEIPT OF PROPOSALS

Any questions regarding this solicitation must be in writing and directed to the procurement officer at the email address listed below. The interested party must confirm telephone conversations in writing.

Two types of questions generally arise. One may be answered by directing the questioner to a specific section of the RFP. These questions may be answered in writing via email directly to the requestor. Other questions may be more complex and may require a written amendment to the RFP. The procurement officer is responsible for making the determination and will respond to the requestor in writing via email.

PROCUREMENT OFFICER: Lisa Trombi, Email: doa.oppm.procurement@alaska.gov

SEC. 1.08 RETURN INSTRUCTIONS

Offerors must submit their proposals via email to doa.oppm.procurement@alaska.gov with the RFP number 2025-0200-0177 / 02-101-25 in the subject line. The offeror’s technical proposal and cost proposal must be submitted as separate and clearly labeled attachments. Such as “Vendor A – Technical Proposal.pdf” and “Vendor A – Cost Proposal.pdf”. The email must contain the RFP number in the subject line.

The maximum size of a single email (including all text and attachments) that can be received by the State is 20mb (megabytes). If the email containing an offeror’s proposal exceeds this size, the proposal must

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be sent in multiple emails that are each less than 20 megabytes, and each email must comply with the requirements described above.

Please note that email transmission is not instantaneous. Similar to sending a hard copy proposal, if you are emailing your proposal, the State recommends sending it with enough time to ensure the email is delivered by the deadline for receipt of proposals. Any proposal received after the deadline for receipt of proposals, as provided in Section 1.03, will not be considered.

It is the offeror’s responsibility to contact the procurement officer at doa.oppm.procurement@alaska.gov to confirm that the proposal has been received. The State is not responsible for unreadable, corrupt, or missing attachments.

SEC. 1.09 ASSISTANCE TO OFFERORS WITH A DISABILITY

Offerors with a disability may receive accommodation regarding the means of communicating this RFP or participating in the procurement process. For more information, contact the procurement officer no later than ten days prior to the deadline for receipt of proposals.

SEC. 1.10 AMENDMENTS TO PROPOSALS

Amendments to or withdrawals of proposals will only be allowed if requests are received in writing prior to the deadline that is set for receipt of proposals. No amendments or withdrawals will be accepted after the deadline unless they are in response to the State's request in accordance with 2 AAC 12.290.

SEC. 1.11 AMENDMENTS TO THE RFP

If an amendment is issued before the deadline for receipt of proposals, the amendment will be posted on the State of Alaska Online Public Notice (OPN) website. The link to the posting of the amendment will be provided to all who were notified of the RFP and to those who have registered with the procurement officer after retrieving the RFP from the OPN website.

After receipt of proposals, if there is a need for any substantial clarification or material change in the RFP, an amendment will be issued. The amendment will incorporate the clarification or change and will inform offerors of the new deadline for receipt of proposals if one has been established. In such an event, an offeror may submit a new or amended proposal or may withdraw its proposal before the time and date set for receipt of proposals, in the manner described in 2 AAC 12.140.

SEC. 1.12 RFP SCHEDULE

The RFP schedule set out below represents the State’s best estimate of the schedule that will be followed. If a component of this schedule, such as the deadline for receipt of proposals, is delayed, the rest of the schedule may be shifted accordingly. All times are Alaska Time.

ACTIVITY TIME DATE

Issue Date / RFP Released Oct 16, 2025 Pre-Proposal Teleconference 10:00 AM AK Time Oct 28, 2025 Intent to Propose and Non-Disclosure Agreement Due No Later Than 2:00 PM AK Time Nov 6, 2025

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Last Day for Question Submittal Nov 10, 2025 Deadline for Receipt of Proposals / Proposal Due Date 11:00 AM AK Time Dec 15, 2025 Initial Proposal Evaluation Meeting (approximately week of) Feb 2, 2026 Interviews (approximately week of) Mar 2, 2026 Proposal Evaluations Completed (approximately week of) Mar 9, 2026 Clarification Period (approximately week of) Mar 23, 2026 Negotiations (approximately week of) Apr 6, 2026 Notice of Intent to Award (approximately) Apr 20, 2026 Contract Start Date Jul 1, 2026

This RFP does not, by itself, obligate the State. The State's obligation will commence only after the contract is approved by the Commissioner of the Department of Administration, or the Commissioner's designee and the contract resulting from this RFP has been fully executed by all parties. The State will not be responsible for any work done by the contractor, even work done in good faith, if it occurs prior to the contract start date established in the fully executed contract.

SEC. 1.13 PRE-PROPOSAL TELECONFERENCE

A pre-proposal teleconference will be held at 10:00 AM, Alaska Time, on October 28, 2025, via Microsoft Teams meeting. Approximately two days before it is scheduled to occur, registered offerors shall be sent an email with details on how to join the teleconference. Attendance is not mandatory.

The purpose of the teleconference is to discuss the work to be performed with the prospective offerors and allow them to ask questions concerning the RFP. Prospective Offerors are encouraged to send questions in writing to doa.oppm.procurement@alaska.gov prior to the teleconference. All questions raised during the meeting must be submitted in writing to the procurement officer and will be posted along with the answers on the Alaska Online Public Notice website as an amendment to the RFP as soon as possible after the teleconference.

A prospective offeror with a disability who needs a special accommodation in order to participate in this teleconference should contact the procurement officer at doa.oppm.procurement@alaska.gov prior to the date set for the pre-proposal teleconference to ensure that necessary accommodation can be provided.

SEC. 1.14 ALTERNATE PROPOSALS

Offerors may only submit one proposal for evaluation. In accordance with 2 AAC 12.830 an alternate proposal, or a proposal that offers something different than what is requested, will be rejected as nonresponsive.

SEC. 1.15 NEWS RELEASES

News releases related to this RFP must not be made without prior approval of the State. Requests must be submitted in writing and sent to doa.oppm.procurement@alaska.gov.

mailto:doa.oppm.procurement@alaska.gov

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SECTION 2. BACKGROUND INFORMATION

SEC. 2.01 BACKGROUND INFORMATION

The Department of Administration, Division of Retirement and Benefits (DRB) manages the State of Alaska’s retirement plans, the state‐sponsored AlaskaCare health and dental plans, and other state-sponsored optional benefits.

The Commissioner of the Department of Administration is the AlaskaCare Plan Administrator and has delegated policy development and operational duties to the Division. Under the leadership of the Division Director, DRB is organized into several sections as follows:

• Health Plan Administration: This section administers and manages the AlaskaCare health plans and other optional benefits, manages the associated vendors, manages health plan eligibility, and internally handles work related to health plan customer service, benefits processing, and appeals.

• Finance: This section provides accounting services and payroll services including retiree and refund processing and employer payroll support.

• Pension and Member Benefits: This section provides counseling to members, customer service through the Member Education Center, processes retirement benefit appeals, provides information technology and special project support, and processes related to disability and death, retirement, and survivor benefits.

• Operations: This section provides administrative services, communications support, information services, and conducts internal auditing/compliance activities.

SEC. 2.02 ABOUT ALASKACARE

AlaskaCare is the name of the State of Alaska’s medical, pharmacy, dental, vision, and audio plans administered by the Division. These plans are provided in accordance with Alaska Statutes to:

1. A portion of State employees;

2. Defined Benefit (DB) retired employees of the State, teachers, and participating political subdivision employers; and

3. Defined Contribution (DC) retired employees of the State, teachers, and participating political subdivision employers.

The plans have different provisions and funding structures, but the State's group health and dental plans are self‐ funded. The coverage provided includes international claims for retiree plan members.

The AlaskaCare plans have many members who are covered by more than one AlaskaCare plan. This can be through coverage as a member and a dependent of their spouse, or through two or more of their own plans (e.g., employee plan and retiree plan, or multiple retirement plans). In general, the active employee and retiree pharmacy plans allow coordination of benefits up to 100% of the recognized charge. Exceptions are discussed in further detail below.

More information about all AlaskaCare health benefits is available at www.AlaskaCare.gov.

http://www.alaskacare.gov/

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AlaskaCare Retiree Health Benefits

The Division offers the following pharmacy benefit options to retirees:

1. AlaskaCare Defined Benefit Retiree Health Plan: This plan provides medical and pharmacy benefits to eligible DB retirees automatically upon retirement. This plan is an older plan design that has undergone limited updates since 2000. However, in 2019, a Medicare Part D Enhanced Employer Group Waiver Plan (EGWP) was implemented into this plan. There are over 76,000 covered lives in this plan encompassing subscribers and dependents, approximately 60,500 of whom are Medicare age eligible. Approximately 55,800 individuals are enrolled in the EGWP portion of the plan. The plan is funded by various retiree health trusts and most plan members are eligible for retirement system-paid benefits. Plan members who are eligible for retirement system-paid benefits do not pay a monthly premium out-of-pocket for health coverage for the member and any eligible dependents.

2. AlaskaCare Defined Contribution Retiree Health Plan: This plan provides medical and pharmacy benefits to eligible DC retirees who elect to participate after termination of employment. This plan was first implemented in 2016 and is a more modern plan design. In 2019, a Medicare Part D Enhanced EGWP was implemented into this plan. There are fewer than 300 covered lives in this plan encompassing subscribers and dependents. Approximately 250 individuals are enrolled in the EGWP portion of the plan. This plan is funded by various retiree health trusts, and all members in this plan are required to pay monthly premiums that vary depending on a number of factors. Eligible members may elect to use a state-sponsored Health Reimbursement Arrangement (HRA) account to pay or offset their monthly premiums.

Alaska Statute 39.35.535 (b) requires that the coverage for members aged 65 or older is the same coverage available to members under the age of 65 and that the AlaskaCare retiree health plans become supplemental to Medicare when members turn 65. Retiree health benefits are protected against diminishment by the Alaska Constitution. As a result, relatively few changes have been made to the retiree health plans since 2000, and any potential future changes must be carefully considered.

The Division works with the Alaska Retiree Health Plan Advisory Board (RHPAB) to analyze and evaluate potential changes to the AlaskaCare Retiree Health Plans. The RHPAB is advisory in nature and makes recommendations to the Plan Administrator related to the retiree health plans.

AlaskaCare Active Employee Benefits

The Division offers the following pharmacy benefit options to eligible active employees:

1. AlaskaCare Active Employee Health Plan: This plan provides medical, pharmacy, and audio benefits to eligible State of Alaska employees and their dependents. Eligible employees may, on an annual basis, elect to opt out of coverage. The Division offers eligible employees a choice between three plan options with different medical cost-share provisions, but the same coverage benefit provisions, including the Standard Plan, the Economy Plan, and the Consumer Choice Plan. The pharmacy cost-share provisions are the same in all three plan options. The plan is actively managed by the Division. There are approximately 15,000 covered lives in the employee medical plan encompassing subscribers and dependents. The plan is primarily financially supported by employer contributions and monthly employee premiums.

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The Division works with the Health Benefits Evaluation Committee (HBEC), made up of union and management representatives, to analyze and evaluate potential changes to the AlaskaCare Employee Health Plans. The HBEC is advisory in nature and makes recommendations to the Plan Administrator related to the employee health plans.

SEC. 2.03 CURRENT PLAN DEFINITIONS

The following information provides definitions which apply to both Commercial and EGWP Plans with enhanced plan design.

1. 340B Claim is a claim that is identified from a pharmacy which has a 340B status code of “38” or “39” in the NCPDP DataQ database, or a claim with a claim status code of "20". Additionally, a 340B Claim could mean any other claim identified by receiving 340B program discounts, pricing, or concessions.

2. Average Wholesale Price (AWP) is based on a date sensitive, 11-digit National Drug Code (NDC) as supplied by a nationally recognized pricing source (i.e., Medi-Span) for retail, mail order, and specialty adjudicated claims.

3. Authorized Generic is a brand drug that is marketed without the brand name on its label. Authorized generic drugs are therapeutically equivalent to its brand drug having the same active and inactive ingredients and is included on the FDA Listing of Authorized Generics as of the dispense date of the prescription.

4. Biosimilar is a biological product that is approved by the FDA as being highly similar to an FDA-approved biologic drug, or reference product. Biosimilar drugs have no clinically meaningful difference in safety, purity or potency when compared to the reference product.

5. Brand Drug is a drug with a Medi-Span code of "M" (co-branded product), "N" (single-source brand) or "O" (original product) as of the dispense date of the prescription based on the NDC-11 code of the prescription.

6. Cash Card Program is any program where members receive prescriptions through a PBM-program or third-party vendor that compares cash discounted drug prices to typical usual and customary prices and navigates the member to the lowest cost pharmacy or overrides the cost at their current pharmacy to match the lowest cost price.

7. Generic Drug is an FDA approved drug that is pharmaceutically equivalent and interchangeable with a brand drug counterpart with an identical amount of the same active ingredient(s). Generic drugs have either a Medi-Span code of "Y" (generic) or a Medi-Span code of "N" or "O" with a Dispense as Written (DAW) Code of 5 as of the dispense date of the prescription based on the NDC-11 code of the prescription.

(Generic drugs include Single-Source Generics, Multi-Source Generics, Authorized Generics, generic products involved in patent litigation and House Generics.)

8. House Generic is a drug that is submitted with a DAW code of 5.

9. Limited Distribution Drug (LDD) is a specialty drug only available by a limited number (e.g., less than three) of specialty pharmacy providers.

10. Maximum Allowable Cost (MAC) is the maximum allowable unit cost of a drug and establishes an upper limit reimbursement price for certain drugs dispensed without regard to the specific manufacturer whose drug is dispensed, and which drugs are identified on a “MAC List”.

11. Members are all eligible employees, and their eligible dependents, enrolled under the plan’s prescription benefit program.

12. Member Copay means members will pay the lowest of the following: Fund copay/coinsurance, Fund-negotiated discounted ingredient cost plus dispensing fee, usual and customary charges (if at retail), MAC (maximum allowable cost) or retail cash price (if at retail) at retail, mail, and specialty pharmacies.

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13. Over-the-Counter Claim (OTC) is a claim for a drug that does not require a prescription for a member to purchase and the plan has decided to include as a covered product with a prescription. OTC Claims are further defined as having an "O" or "P" in Medi-Span's Rx-OTC Indicator Code.

14. Paid Claims are all transactions made on eligible members that result in a payment to pharmacies or members from the plan or the member copays. (Does not include reversals, rejected claims and adjustments.) Each unique prescription that results in payment shall be calculated separately as a paid claim.

15. Pass-through Pricing is the invoicing to the plan for a specific prescription that is equal to the amount reimbursed to the pharmacy for a specific prescription on behalf of the plan by the PBM.

16. PEPM stands for per employee or retiree per month.

17. PMPM stands for per member per month.

18. Pricing Channel is either retail or Retail-30 pharmacies, Retail-90 or Retail-Plus pharmacies, mail order pharmacies or the PBM's specialty pharmacy.

19. Rebates is compensation or remuneration of any kind received or recovered from a pharmaceutical manufacturer attributable to the purchase or utilization of covered drugs by eligible persons, including, but not limited to, incentive rebates categorized as purchase discounts; credits; rebates, regardless of how categorized; market share incentives; promotional allowances; commissions; educational grants;

market share of utilization; drug pull-through programs; implementation allowances; clinical detailing;

rebate submission fees; and administrative or management fees. Rebates also include any fees that PBM receives from a pharmaceutical manufacturer for administrative costs, formulary placement, and/or access.

20. Single Source Generic (SSG) is a generic drug that is only manufactured by one generic drug manufacturing company, which includes a brand drug with a Medi-Span code = "O".

21. Specialty Drug means a drug or product used to treat complex and rare diseases and requires at least four of the following:

a. A medication used to treat complex or rare conditions;

b. Injectable or infused medication;

c. A medication that requires special packaging, handling, administration and/or monitoring;

d. High cost medication;

e. A biologic medication targeting a specific part of the disease process; and

f. A medication dispensed via a limited number of pharmacies.

22. Usual and Customary (U&C) is a pharmacy's usual selling price that a cash paying customer pays for prescription drugs.

23. Zero Balance Due (ZBD) Claim is a claim where the member pays the total amount of the discounted ingredient cost plus dispensing fee and any applicable sales tax.

24. 100% Pass Through of Rebates means the PBM passes through 100% of ALL pharmaceutical manufacturer revenue earned to the plan and does not charge an administrative fee for this arrangement. The PBM discloses details of all other programs and services generating financial remuneration from outside entities, including manufacturers and retailers. All of this revenue is verifiable and auditable.

SEC. 2.04 CURRENT PLAN FEATURES AND COVERAGE

The following information provides an overview of current pharmacy plan features and coverage. Offeror should consider current programs and vendor relationships but should also consider the potential for program changes at the discretion of the State.

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The Division administers three self-funded separate pharmacy benefit plans for the following groups:

1. Defined Benefit (DB) retirees

2. Defined Contribution (DC) retirees

3. Active employees

Both retiree pharmacy plans include an EGWP component for eligible members, but the enhanced wrap of benefits in each plan functions to ensure that from a member perspective, the EGWP benefits mirror the non- EGWP benefits.

The State of Alaska currently has a broad retail pharmacy network that covers all major retail networks and is seeking a similar broad retail network that covers all major retail networks as well as Alaskan independent pharmacies.

The State requires offerors to replicate all current plan designs, and all offerors must be able to administer the benefits as outlined in the existing plan booklets. Links provided below.

Retiree Defined Benefit (DB) Pharmacy Plan

The DB retiree plan full details can be found in the summary of plan benefits available online at:

https://drb.alaska.gov/docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf.

The DB retiree plan combines EGWP, non-EGWP (i.e., not eligible for EGWP due to age or other qualifying reasons) and EGWP-opt out members (i.e., eligible for EGWP, but choose to opt-out). The member cost-share provisions for EGWP and non-EGWP members are the same, while the member cost-share provisions for individuals who are eligible for but chose to opt-out of the EGWP program are different. Covered benefits and other plan provisions for all populations, including EGWP, non-EGWP, and EGWP opt-out, are the same and consistency must be maintained.

Key features include:

1. Member Cost Share: Most DB retiree plan members have access to the DB retiree standard benefit cost-share provisions detailed below in Table 1. DB retiree plan members who are eligible for but have chosen to opt out of the EGWP program have access to the DB retiree EGWP opt-out benefit cost-share provisions detailed below in Table 2.

TABLE 1: DB RETIREE STANDARD BENEFIT (EGWP & NON-EGWP)

Generic: Up to 90 Day or

100 Unit Supply Brand: Up to 90 Day or 100 Unit Supply

Network Pharmacy Copayment $4 $8 Mail Order Copayment $0 $0

TABLE 2: DB RETIREE EGWP OPT-OUT BENEFIT

Prescription Tier Coinsurance Minimum Covered

Person Payment Maximum Covered Person Payment

Retail 30 Day at Network Pharmacy Generic Prescription Drug 80% $10 $50 Preferred Brand-Name Prescription Drug

75% $25 $75 https://drb.alaska.gov/docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf

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Non-Preferred Brand-Name Prescription Drug

65% $80 $150

Out-of-Network Pharmacy Coinsurance for all Prescription Drugs

60%

Mail-Order 1-90 Day at Network Pharmacy Prescription Tier Copayment Generic Prescription Drug $20 Preferred Brand-Name Prescription Drug

$50

Non-Preferred Brand-Name Prescription Drug

$100

Out-of-Pocket Limit Annual Individual Out-of-Pocket Limit $1,000 Annual Family Out-of-Pocket Limit $2,000

2. Formulary: The DB retiree plan has an open formulary with minimal exclusions. Exclusions may include non-essential/non-FDA approved/out of scope and medical benefit specialty products. The EGWP Plan’s enhanced wrap of benefits functions to ensure that EGWP members have access to the same covered drugs as non-EGWP members. Current formularies may be found here: https://drb.alaska.gov/retiree/ healthplans.html#retireeformulary.

3. Non-Standard Coverage: The DB retiree plan covers medication that is often excluded under other plans, such as bulk chemical compounds and certain medications with an over-the-counter equivalent.

4. Out-of-Network Pharmacies: The retiree DB EGWP and non-EGWP cover out-of-network pharmacies.

5. Prior Authorizations: Prior Authorizations (PAs) are very limited in the DB retiree plan. PAs in place include those for specialty medications, certain opioids, for the DB EGWP Plan, and for those required by Medicare Part D.

6. Coordination of Benefits: The retiree DB EGWP and non-EGWP Plans have robust coordination of benefit provisions detailed in Section 15.1 of the 2025 AlaskaCare Retiree Insurance Information Booklet:

https://drb.alaska.gov/docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf. In addition to coordinating with other health coverage, these plans will coordinate internally if a member has multiple coverages, either through their own AlaskaCare coverage and AlaskaCare coverage they have through their spouse, or through retiring into more than one qualifying retirement system. The retiree DB EGWP opt-out plan is exempt from the coordination of benefits provisions. Active employee and retiree plans will coordinate together. This currently includes 92,375 members.

7. Benefit Exclusions: There are limited benefit exclusions under the retiree DB prescription drug plan.

Please see Section 4.8 of the 2025 AlaskaCare Retiree Insurance Information Booklet:

https://drb.alaska.gov/docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf.

https://drb.alaska.gov/retiree/healthplans.html#retireeformulary

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8. Specialty Pharmacy: The DB retiree plan does not include an exclusive specialty pharmacy arrangement.

Members may fill specialty drugs from the pharmacy of their choice. The plan allows for 90-day specialty drug fills.

9. Mail Order: The DB retiree plan offers an optional mail order program through the current PBM. Members are not prohibited from legally obtaining prescription drugs via mail from other retail pharmacies, but the $0 member copay is only associated with drugs obtained through the PBM’s mail order/home delivery program.

10. International Claims: Approximately 700 DB retiree plan members live overseas. The contract awardee must be prepared to support international claims submissions, including PA requests.

11. Appeal Process: The DB retiree plan provides members rights to a four-level appeal process, detailed in section 13.14 of the 2025 AlaskaCare Retiree Insurance Information Booklet: https://drb.alaska.gov/ docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf. If an EGWP member receives a claim or PA denial, they must be provided with AlaskaCare appeals rights in addition to any federally mandated Medicare Part D appeals rights. All level one and level two AlaskaCare pharmacy benefit appeals are administered by the pharmacy plan claim administrator / PBM.

Retiree Defined Contribution (DC) Pharmacy Plan

The DC retiree plan full details can be found in the summary of plan benefits available online at:

https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf.

The DC retiree plan combines EGWP, non-EGWP (i.e., not eligible for EGWP due to age or other qualifying reasons) and EGWP-opt out members (i.e., eligible for EGWP, but choose to opt-out). The member cost share provisions for EGWP and non-EGWP members are the same, while the member cost share provisions for individuals who are eligible for but chose to opt-out of the EGWP program are different. Covered benefits and other plan provisions for all populations, including EGWP, non-EGWP, and EGWP opt-out, are the same and consistency must be maintained.

Key features include:

1. Member Cost Share: Most DC retiree plan members have access to the DC retiree standard benefit cost share provisions detailed below in Table 3. DC retiree plan members who are eligible for but have chosen to opt out of the EGWP program have access to the DC retiree EGWP opt-out benefit cost share provisions detailed below in Table 4.

TABLE 3: DC RETIREE STANDARD BENEFIT (EGWP & NON-EGWP)

Prescription Tier Coinsurance Minimum Covered

Person Payment Maximum Covered Person Payment

Retail 30 Day at Network Pharmacy Generic Prescription Drug 80% $10 $50 Preferred Brand-Name Prescription Drug

75% $25 $75

Non-Preferred Brand-Name Prescription Drug

65% $80 $150 https://drb.alaska.gov/docs/booklets/DB-RetireeInsuranceBooklet_WEB.pdf https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf

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Out-of-Network Pharmacy All Prescription Drugs 60%

Mail-Order 31-90 Day at Network Pharmacy Prescription Tier Copayment Generic Prescription Drug $20 Preferred Brand-Name Prescription Drug

$50

Non-Preferred Brand-Name Prescription Drug

$100

Out-of-Pocket Limit Annual Individual Out-of-Pocket Limit $1,000 Annual Family Out-of-Pocket Limit $2,000

Special Note Insulin member cost sharing maximum of $35 per 30-day supply

TABLE 4: DC RETIREE EGWP OPT-OUT BENEFIT

Prescription Tier Coinsurance Minimum Covered

Person Payment Maximum Covered Person Payment

Retail 30 Day at Network Pharmacy Generic Prescription Drug 70% $15 $75 Preferred Brand-Name Prescription Drug

65% $30 $90

Non-Preferred Brand-Name Prescription Drug

55% $90 $175

Out-of-Network Pharmacy All Prescription Drugs 50%

Mail-Order 31-90 Day at Network Pharmacy Prescription Tier Copayment Generic Prescription Drug $35 Preferred Brand-Name Prescription Drug

$75

Non-Preferred Brand-Name Prescription Drug

$125

Out-of-Pocket Limit Annual Individual Out-of-Pocket Limit $2,000 Annual Family Out-of-Pocket Limit $4,000

2. Formulary: The DC retiree plan has an open formulary with minimal exclusions. Exclusions may include non-essential/non-FDA approved/out of scope and medical benefit specialty products. The EGWP Plan’s enhanced wrap of benefits functions to ensure that EGWP members have access to the same covered drugs as non-EGWP members. Current formularies may be found here: https://drb.alaska.gov/retiree/ healthplans.html#retireeformulary.

3. Prior Authorizations: PAs are very limited in the DC retiree plan. Existing PAs include those for specialty medications, certain opioids, for the DC EGWP Plan, and for those required by Medicare Part D.

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4. Coordination of Benefits: The retiree DC EGWP and non-EGWP Plans have robust coordination of benefit provisions detailed in Section 13 of the 2025 AlaskaCare Retiree Defined Contribution Insurance Information Booklet: https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf. In addition to coordinating with other health coverage, these plans will coordinate internally if a member has multiple coverages, either through their own AlaskaCare coverage and AlaskaCare coverage they have through their spouse, or through retiring into more than one qualifying retirement system. The retiree DC EGWP opt-out plan is exempt from the coordination of benefits provisions. Active employee and retiree plans will coordinate together.

5. Benefit Exclusions: There are limited benefit exclusions under the retiree DC prescription drug plan.

Please see Section 3.6.21 of the 2025 AlaskaCare Retiree Defined Contribution Insurance Information Booklet: https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf.

6. Specialty Pharmacy: The DC retiree plan does not include an exclusive specialty pharmacy arrangement.

Members may fill specialty drugs from the pharmacy of their choice. The plan allows for 90-day specialty drug fills.

7. Mail Order: The DC retiree plan offers an optional mail order program through the current PBM. Members are not prohibited from legally obtaining prescription drugs via mail from other retail pharmacies.

8. International Claims: The contract awardee must be prepared to support international claims submissions, including PA requests.

9. Appeal Process: The DC retiree plan provides members rights to a four-level appeal process, detailed in Section 11.14 of the 2025 AlaskaCare Retiree Defined Contribution Insurance Information Booklet:

https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf. If an EGWP member receives a claim or PA denial, they must be provided with AlaskaCare appeals rights in addition to any federally mandated Medicare Part D appeal rights. All level one and level two AlaskaCare pharmacy benefit appeals are administered by the pharmacy plan claim administrator / PBM.

Active Employee Pharmacy Plan

The State of Alaska administers three self-funded medical plans, including the Economy Plan, Standard Plan, and Consumer Choice Plan. The Consumer Choice Plan is a consumer directed health plan (CDHP) for active State employees. Though the member cost-share for medical services differs between each plan option, the prescription drug cost share and coverage provisions do not.

The active employee plan full details can be found in the summary of plan benefits available online at:

https://drb.alaska.gov/docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf.

Key features include:

1. Member Cost Share:

TABLE 1. ACTIVE EMPLOYEE BENEFIT

Prescription Tier Copayment/Coinsurance

Retail 1-30 Day Supply: Network Pharmacy Maintenance Generic Drug $5 Generic Prescription Drug $10 https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf https://drb.alaska.gov/docs/booklets/DCR-RetireeHealthPlanBooklet_WEB.pdf https://drb.alaska.gov/docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf

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Preferred Brand-Name Prescription Drug $35 Non-Preferred Brand-Name Prescription Drug 65% coinsurance with $80 min/$150 max

Out-of-Network Pharmacy All Prescription Drugs 60% coinsurance

Mail-Order 31-90 Day: Network Pharmacy Maintenance Generic Drug $10 Generic Prescription Drug $20 Preferred Brand-Name Prescription Drug $50 Non-Preferred Brand-Name Prescription Drug $100

Out-of-Pocket Limit Annual Individual Out-of-Pocket Limit $1,000 Annual Family Out-of-Pocket Limit $2,000 *Note: Members may request a tier exception if there is a clinical reason why they must use a medication in the highest cost share tier. If the tier exception is granted, the member pays a lower cost share.

2. Formulary: The active employee plan has a managed formulary with exclusions to drive value. Exclusions also may include clinical duplicates, high-cost brands, non-essential/non-FDA approved/out of scope, non-essential pain creams/patches, medical benefit specialty, and new drugs to market. The current formulary may be found here: https://drb.alaska.gov/employee/healthplans.html#formulary.

3. Prior Authorizations: The active employee plan includes most standard PAs.

4. Coordination of Benefits: The active employee plan has robust coordination of benefit provisions detailed in Section 11 of the 2025 AlaskaCare Employee Insurance Information Booklet: https://drb.alaska.gov/ docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf. In addition to coordinating with other health coverage, this plan will coordinate internally if a member has multiple coverages through their own AlaskaCare coverage and AlaskaCare coverage they have through their spouse. Active employee and retiree plans will coordinate together.

5. Benefit Exclusions: There are limited benefit exclusions under the active employee prescription drug plan.

Please see Section 3.6.16 of the 2025 AlaskaCare Employee Insurance Information Booklet:

https://drb.alaska.gov/docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf.

6. Specialty Pharmacy: The active employee plan has an exclusive specialty pharmacy arrangement with the current PBM. Except in limited circumstances, members must fill specialty medications through the PBM’s specialty pharmacy. The plan will allow for 90-day fills of specialty medications.

7. Mail Order: The active employee plan offers an optional mail order program through the current PBM.

Members are not prohibited from legally obtaining prescription drugs via mail from other retail pharmacies, but the reduced mail-order member copays are only associated with drugs obtained through the PBM’s mail order/home delivery program.

8. Variable Copay/Accumulator Adjustment Program: The active employee plan includes a variable copay program and associated accumulator adjustment program to leverage available manufacturer coupons.

https://drb.alaska.gov/employee/healthplans.html#formulary https://drb.alaska.gov/docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf

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9. International Claims: The contract awardee must be prepared to support international claims submissions, including PA requests.

10. Appeal Process: The active employee plan provides members rights to a four-level appeal process, detailed in Section 8.14 of the 2025 AlaskaCare Employee Insurance Information Booklet:

https://drb.alaska.gov/docs/booklets/AC-EmployeeHealthPlanBooklet_WEB.pdf. All level one and level two AlaskaCare pharmacy benefit appeals are administered by the pharmacy plan claim administrator /

PBM.

11. Opting Out: State employees eligible to enroll in the active employee plan may elect to opt out of or waive any type of coverage for themselves or their family. This must be done on an annual basis.

SEC. 2.05 CURRENT FINANCIAL CONTRACT AND STRUCTURE

The current PBM contractor is Optum Rx. This contract has been in place since January 1, 2019. The State’s current contract includes traditional pricing terms for the active employee and commercial retiree populations and transparent pricing terms for the EGWP retiree populations. All populations have 100% rebate pass-through/transparent pricing terms. Current duties include, but are not limited to the following:

1. Claims adjudication;

2. Pricing administration;

3. Pharmacy network access, management, and expansion;

4. Formulary management;

5. Rebate management;

6. Integration with other vendors at the direction of the State, e.g., disease management, medical, data warehouse vendors;

7. Eligibility maintenance;

8. Medicare Part D EGWP administrative services including access to an online system providing covered participants and dependents with a designated contact for issue resolution and reconciliation;

9. Income Related Monthly Adjustment Amount (IRMAA) reimbursement process management. Third party vendor may be used to carve out this benefit but must be disclosed to the State;

10. Retiree Drug Subsidy (RDS) administrative services;

11. Paper claims submission with a process to allow for compounded drug claims and foreign claims;

12. Online access capabilities including prior authorization and override entries;

13. Coordination of benefits support services;

14. Subrogation support services;

15. Comprehensive IT capabilities including access to claims history with denial reasons;

16. Appeals process support;

17. Discount programs for non-covered drugs or cash claims;

18. Clinical programs including PAs, evidence-based clinical policies, patient and provider education, clinical support; prospective, concurrent, and retrospective drug utilization review, medication compliance, and analysis of individual’s prescription drug claims to identify opportunities to improve care, prevent misuse, and reduce waste;

19. Standard and ad-hoc data reporting;

20. Provides data feed to other external vendors as directed by the State;

21. Distribution of ID Cards and pharmacy directories;

22. Mail service/home delivery pharmacy including optional auto-renewal and auto-refill programs;

23. Specialty pharmacy services;

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24. Member services including claims resolution, claims appeals, clinical support and patient and provider education, and a dedicated website with a membership portal;

25. State account services including designated account management and customer service representative telephonic support with access to call history and historical claims data;

26. Coordination with HRA administrator; and

27. Variable Copay Program with the Employee plan.

Different aspects of the services are provided in different geographical locations, but all services must be provided in the United States.

SEC. 2.06 HISTORICAL FACTS AND FIGURES

TABLE 6: SUMMARY OF SERVICES (JUNE 1, 2024 – MAY 31, 2025)

Description Active Employee

Plan

Commercial Retiree Plan

(non-EGWP)*

EGWP Retiree Plan

Total

Average Member Count

16,000 23,500 47,300 86,900

Annual Rx Count 122,900 323,400 1,238,600 1,684,900

Total Drug Cost

(AWP)

$75,193,400 $198,443,500 $718,761,500 $992,398,400

Mail Order Utilization

4.8% 10.9% 16.6% 14.6%

Generic Utilization 79.7% 77.9% 80.1% 79.6%

Specialty Utilization

1.2% 1.3% 1.1% 1.2%

*NOTE: There are members who are Medicare eligible on the Commercial Retiree plan that are part of the Opt Out plan, these members are eligible to be in EGWP but choose not to be or are counted in the “Over 65 who cannot be on EGWP File, but did not Opt Out” category.

SEC. 2.07 UNIQUE CONSIDERATIONS

AlaskaCare members can earn multiple retiree health plan benefits. This can result in an individual having two or more of their own plans under the AlaskaCare retiree plan, as well as coverage as dependent if they are married to another retiree or State of Alaska employee. This requires the AlaskaCare plan to customize plan coordination to address the multiple plans for a single member.

AlaskaCare membership is spread throughout Alaska from our main population hubs of Anchorage and Fairbanks to small villages of less than 100 residents. Only 20% of Alaska is accessible by road, and due to Alaska’s size, even communities connected by roads can still be eight or more hours drive away from population centers. There are members who live in rural locations and major commercial airlines do not provide service to most of these areas.

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Many communities, particularly in Southeast Alaska, have no road connections outside of their locale, so aircraft and boats are the major means of transport.