S000000161 Q and A.pdf

Question Subject Question Text Answer 1 10 Years in Business

Requirement Hi Team, we'd love nothing more than to submit a bid as our best-in-class service and cost-plus financial model could be a perfect fit for the state plan/members, however that is the only requirement we do not currently meet. Are you willing to offer an exemption on that particular requirement? Thank you in advance for your consideration.

No, we are not able to offer an exception to this requirement.

2 Retiree population Understanding the State plan includes retirees, can you share the break out of age 65 and over retirees in the active plan today?

As of 11/10/2022:

Post 65 Retirees counts: ASE - 11,270 Some retirees may move to MA/PD on 1/1/2023

3 Pharmacy Network Which pharmacies are included in the ?Arkansas Independents & Associations? network?

See Attachment G

4 Pharmacy Network Aside from the pharmacies included, how does the ?Arkansas Independents & Associations? network differ from a standard broad retail network? What is the goal or reason for a separate ?Arkansas Independents & Associations? network?

Currently, Arkansas Independents and Associations network is subject to a different network discount rate. Arkansas is a rural state and relies heavily on a complete independent network. Aggressively low reimbursement rates that might apply to chains or metropolitan areas are not pertinent to Arkansas' pharmacy landscape.

5 Formulary Will the State of Arkansas provide the custom formulary list? Yes.

6 Formulary Disruption Will disruptions be run on each potential contractor?s exclusive or broad formularies, or are does the State want a disruption based on a fully customized formulary?

EBD requires the disruption to be based off Contractor's lowest net cost formulary compared to claims data.

7 Technical Proposal Packet Page Limit

Does the 35 page limit for the Technical Response include the initial 6 pages of the Technical Proposal Packet, or is it appropriate to incorporate our response within the template for a total of 41 pages?

A Prospective Contractor's response under the Information for Evaluation sections should not exceed 35 pages. This does not include any other requested documents, the title page, Signature Page, etc.

8 Solicitation S000000110 General Question

Please confirm that there are no EGWP members currently, only

RDS.

Yes, that is correct. There are no EGWP members currently.

9 Solicitation S000000110 General Question

Please clarify the 35 page limit. In the Technical Proposal, it is stated that the 35 pages is inclusive of Experience, Solution, Risk, and Recommended Options. However, in the Bidders Conference PowerPoint it states Experience, Solution, Risk, and Cost Proposal.

See response to Question 7.

10 Solicitation S000000110 General Question

Please provide the Name and NPIs of the pharmacies in the Arkansas Independent Retail Pharmacies Network.

See Attachment G.

11 Solicitation S000000110 General Question

Can you provide your custom formulary and UM rules? Custom formulary and UM criteria were provided as part of solicitation and linked below.

https://www.transform.ar.gov/wp-content/uploads/2022/01/January-Preferred- Drug-List.pdf chrome-extension://efaidnbmnnnibpcajpcglclefindmk aj/https://www.transform.ar.gov/wp-content/uploads/October-2022-EBRx-PA- Criteria-Master-File.pdf

12 Solicitation S000000110 Technical Proposal Solution C 3

Please clarify if we can provide a separate attachment, outside of the 35 page requirements showing our sample reporting. Per the RFP 1.8D, it states we cannot provide any additional documents.

Technical Response Solutions C 3, asks for utilization report samples. Due to the size of our samples, this will exceed the 35 page limit.

See response to Question 7.

13 Network reimbursement rate

The EBD RFP has asked bidders to provide a separate network guarantee for Arkansas Independents. Current Arkansas NADAC legislation mandates that a pharmacy benefits manager or representative of a pharmacy benefits manager shall not pay or reimburse a pharmacy or pharmacist for the ingredient drug product component of pharmacist services less than the national average drug acquisition cost or, if the national average drug acquisition cost is unavailable, the wholesale acquisition cost. EBD is currently exempt from legislation given additional rate concessions secured by EBRx.

Are we to assume that the deep discount independent guarantees proposed for EBD would not be subject to NADAC legislation? Or would you prefer we quote less aggressive guarantees aligning with NADAC requirements? Would you please confirm that PBM would not be subject to any fines related to pharmacy complaints resulting from guarantee?

EBD currently operates under an exemption to NADAC-specific regulations under Arkansas State Law. However, any contract reached as a result of this solicitation will need to meet the requirements of Arkansas State Law, the requirements of the RFP, and receive legislative approval prior to execution of the contract.

14 1.4 Solicitation Schedule Please clarify when Vendor will be notified of invitation for Discussions Kick Off Meeting.

A notification to attend the Discussions Kick Off Meeting will be communicated in the period of time between the Final Proposal Evaluation and the Discussions Kick Off Meeting as listed on Table A: TENTATVE SOLICITATION SCHEDULE. The State will provide the notification to ensure enough time to prepare for the meeting.

15 1.8 Response Documents ?2. Prospective Contractors shall utilize the Technical Proposal Packet to submit their responses.? Please clarify where in Technical Proposal Packet Vendor should input responses. For example, should Vendor insert responses directly within each table, below each question.

Prospective Contractors are not required to input response directly within each table.

However, Prospective Contractors should not change the order of their response in relation to the Technical Proposal Packet.

For example: Experience A 1-4 responses should be followed by Experience B 1-2 responses.

16 2.5 General Requirements: ?E. The Contractor shall sign and adhere to all requirements contained in the Business Associate Agreement (BAA ).? Please provide a copy of the BAA for Vendor review.

A BAA will be provided as part of discussions at which time any potential changes to the BAA can be contemplated.

17 1.8 Response Documents ?Voluntary Product Accessibility Template (VPAT), if applicable.?

Please clarify whether the VPAT template is applicable to this procurement. If so, please provide template for completion.

The VPAT is not required at this time.

Should the VPAT be determined to be required after proposal submission, any Prospective Contractor must submit prior to a contract award.

18 2.9 PBM Management ?G. The Contractor shall provide weekly and monthly data transmissions (may include feeds to data warehouses) to at least ten (10) chosen vendors at no charge and two (2) additional full, annual electronic claims files, in NCPDP format, as requested by EBD .? Please specify which vendors PBM will be expected to integrate with.

The current list of likely vendors would include Mainstream Technologies, Health Advantage and UnitedHealthcare. However, this list is not exhaustive of all entities the winning vendor will be asked to provide data transmissions to.

19 2.11 Claims Processing Requirements

?A. The Contractor?s claims processing system must fully integrate with the eligibility and member services system.? Please provide the name of the eligibility and member services system.

The eligibility and member services system is referred to ARBenefits and is a custom system created and maintained by EBD's technology partner, Mainstream Technologies.

20 2.23 Performance Standards

Please provide EBD?s performance standards for Vendor review. EBD and the Prospective Contactor that moves forward into the Discussions Phase will discuss performance standards.

21 2.22 Optional EGWP Will EBD consider waiving the following requirement: ?The Contractor shall contract directly with CMS to provide an EGWP.

The Contractor shall not use subcontractors to provide any EGWP services to EBD.?

No, we are not able to offer an exception to this requirement.

22 Attachment B If a custom formulary is required, are all 57,215 NDCs in Attachment B excluded or just the 35,474 drugs that have a non-blank ?Formulary Status Reason??

Currently all 57,215 NDCs listed in the exclusion file are excluded (NC=not covered in formulary status column). The 'formulary status reason' column contains internal incubent PBM codes that would be irrelevant to a different PBM.

23 Cost Proposal/Underwriting Assumptions

Please provide Member Census, monthly member counts over the experience period, and member paid amounts within the provided data OR annual member paid % over the experience period.

Census files can be provided during the Discussions Phase.

24 Cost Proposal/Underwriting Assumptions

Please confirm that Vendor can bid our low net cost formulary and is not required to align with the current custom formulary.

The Prospective Contractor will be required to bid their lowest net cost formulary but this formulary is subject to modification or change at the request of EBD and in consultation with the plan's clinical consultant.

25 Cost Proposal/Underwriting Assumptions

Please provide the NABPs / NPIs of the Arkansas Independents & Associations pharmacies.

See Attachment G.

26 Cost Proposal/Underwriting Assumptions

Please provide the NABPs / NPIs for the pharmacies within the Custom Specialty Network.

See Attachment F.

27 Cost Proposal/Underwriting Assumptions

Please provide the NABPs / NPIs for the pharmacies within the Custom Specialty Network.

See Attachment F.

28 Cost Proposal/Underwriting Assumptions

Does the copay assistance program route prescriptions through the Custom Specialty Network?

Yes.

29 Cost Proposal/Underwriting Assumptions

Is Vendor required to bid assuming the Custom Specialty Network?

If so, is Vendor able to bid with our Mail Partner on top of the Custom Specialty Network?

Yes, the Prospective Contractor is requried to include a Custom Specialty Network as part of its bid. The Prospective Contractor can bid with its Mail Partner on top of the Custom Specialty Network. The Prospective Contractor may propose an arrangement where the Prospective Contractor-owned or Prospective Contractor-contracted Specialty pharmacy joins the open specialty network.

30 Cost Proposal/Underwriting Assumptions

What is the pharmacy benefit for the HDHPs? Are there any additional plan designs beyond the POS and 2 HDHPs?

HDHPs and premium plan share the same formulary. Once deductible in HDHP is met, coinsurance rates begin to apply until the max out of pocket is met.

31 Cost Proposal/Underwriting Assumptions

Please provide a key for the tiers within the data? We see 00, 01, 02, 03, 04, and 05, but the POS plan has 4 tiers.

00= ACA mandate ($0 copay); 01= generic tier ($15 copay); 02= preferred brand tier ($40 copay); 03= non-preferred brand tier ($80 copay); 04= specialty tier ($100 copay);

05= reference based pricing tier.

32 Solicitation number S000000161, question regarding 'Information for Evaluation - Recommended Options

For the RFP Information for Evaluation - Recommended Options, there is no scoring assigned to this. Is this a requirement or an omission?

The Recommended Options form is not scored. However, Prospective Contractors are encouraged to submit the recommended options with their proposal submission.

33 Solicitation number S000000161, question regarding Section 1.10 Pricing Section T

Referencing 1.10 Pricing Section T: Would a consortium of states be a detriment to being accepted as a bidder?

No, there would be no detriment and a consortium of states would be welcome as a bidder if it meets all Arkansas State Laws and other relevant requirements of the RFP

34 Solicitation number S000000161, question regarding 2.15 Formulary Management

Referencing 2.15 Formulary Management: Does EBD, or EBD?s clinical consultant, make formulary determinations for all therapeutic categories or select therapeutic categories. If select categories are managed, can you please provide the categories?

EBD, in conjunction with the clinical consultant, makes formulary determinations for all therapeutic categories.

35 Solicitation number S000000161, question regarding Attachment A:

Non-Disclosure Agreement

Can redlines be submitted for Attachment A: Non-Disclosure Agreement? Alternatively, can a revised Non-Disclosure Agreement be issued? The definition of ?Confidential Information? limits the agreement to protecting only the Purchaser, whereas it appears the intent in the remainder of the document is to enter into a mutual agreement.

No, we will not accept redline exceptions to the NDA.

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