S000000161 Technical Proposal Packet.docx
DOCX document 55 KB Posted
- Attached to
- Pharmacy Benefit Manager
- Solicitation number
- S000000161
- Issued by
- Pulaski County, Arkansas
About this file
This document is a Technical Proposal Packet for solicitation S000000161 issued by the State of Arkansas Employee Benefits Division (EBD). The solicitation requests proposals for a Pharmacy Benefit Manager (PBM) to provide services including custom formulary management, clinical program development, transparent pricing, and detailed reporting. The contract will be awarded to a single PBM provider to serve approximately 130,000 covered lives and 2.5 million annual prescriptions, with a significant portion adjudicated at independent retail pharmacies. Prospective contractors must provide responses addressing experience, proposed solutions, risks, and recommended options, with a 35-page limit. Proposals are due by a specified date, and the contract term will be for an initial period with multiple renewal options.
The solicitation requires detailed pricing guarantees for discounts, dispensing fees, and rebates across various prescription channels, with a focus on transparent pricing and 100% pass-through of all rebates and manufacturer revenue. Contractors must also address formulary management, clinical program development, and audit/market check rights. The State reserves the right to reject formulary changes without financial impact and to remove retail pharmacies from the network as needed.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment B - List of Exclusions~1.xlsx | XLSX spreadsheet | |
| S000000161 Cost Workbook.xlsx | XLSX spreadsheet | |
| S000000161 Pharmacy Benefits Manager.pdf | ||
| Attachment D - Formulary Disruption Reporting~1.xlsx | XLSX spreadsheet | |
| S000000161 Q and A.pdf | ||
| Attachment C - Retail Network Disruption Report~1.xlsx | XLSX spreadsheet | |
| Attachment G Arkansas Independents Network.xlsx | XLSX spreadsheet | |
| Contract and Grant Disclosure~17.pdf | ||
| Attachment A - Non-Disclosure Agreement~1.docx | DOCX document | |
| Attachment E - Financial and Formulary Scoring Examples~1.xlsx | XLSX spreadsheet | |
| Attachment F - Specialty Pharmacy Listing- Revised.xlsx | XLSX spreadsheet | |
| S000000161 - Drug Pricing Product Exclusions.xlsx | XLSX spreadsheet | |
| S000000161 Bidders Conference PPT.pdf |
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
TECHNICAL PROPOSAL PACKET
S000000161
PROPOSAL SIGNATURE PAGE
Type or Print the following information.
PROSPECTIVE CONTRACTOR’S INFORMATION
Company:
Address:
City:
State:
Zip Code:
| Business Designation: |
| ☐ Individual |
| ☐ Sole Proprietorship |
| ☐ Public Service Corp |
| ☐ Partnership |
| ☐ Corporation |
| ☐ Nonprofit |
| Minority and Women-Owned Designation*: |
| ☐ Not Applicable |
| ☐ American Indian |
| ☐ Service Disabled Veteran |
| ☐ African American |
| ☐ Hispanic American |
| ☐ Women-Owned |
| ☐ Asian American |
| ☐ Pacific Islander American |
| AR Certification #: ________________ |
| * See Minority and Women-Owned Business Policy |
PROSPECTIVE CONTRACTOR CONTACT INFORMATION
Provide contact information to be used for RFP solicitation related matters and Project Lead for Interview.
Contact Person:
Title:
Phone:
Alternate Phone:
Email:
CONFIRMATION OF REDACTED COPY
☐ YES, a redacted copy of submission documents is enclosed.
☐ NO, a redacted copy of submission documents is not enclosed. I understand a full copy of non-redacted submission documents will be released if requested.
Note: If a redacted copy of the submission documents is not provided with Prospective Contractor’s response packet, and neither box is checked, a copy of the non-redacted documents, with the exception of financial data (other than pricing), will be released in response to any request made under the Arkansas Freedom of Information Act (FOIA). See RFP Solicitation for additional information.
ILLEGAL IMMIGRANT CONFIRMATION
By signing and submitting a response to this RFP Solicitation, Prospective Contractor agrees and certifies that they do not employ or contract with illegal immigrants and shall not employ or contract with illegal immigrants during the term of a contract awarded as a result of this RFP.
ISRAEL BOYCOTT RESTRICTION CONFIRMATION
By checking the box below, Prospective Contractor agrees and certifies that they do not boycott Israel and shall not boycott Israel during the term of a contract awarded as a result of this RFP.
☐ Prospective Contractor does not and shall not boycott Israel.
An official authorized to bind the Prospective Contractor to a resultant contract shall sign below.
The signature below signifies agreement that any exception that conflicts with a Requirement of this RFP Solicitation may cause the Prospective Contractor’s proposal to be rejected.
| Authorized Signature: | Title: |
| Use Ink Only. | |
| Printed/Typed Name: | Date: |
submission requirements checklist
Per the solicitation, the following items must be submitted with the Prospective Contractor’s proposal:
· Proposal Signature Page
· Proposed Subcontractors Form
· Information for Evaluation (35 pages or less cumulative total for all subsections combined)
· Experience: A
· Experience: B
· Solution: A
· Solution: B
· Solution: C
· Risk
· Recommended Options
· Exceptions Form, if applicable
· S000000161 Cost Workbook
· Name of the proposed lowest net cost Non-Specialty and Specialty Formulary, including the proposed preferred products and tier designations.
· List of the proposed formulary excluded non-specialty and specialty drugs and the therapeutic alternatives.
· Formulary Disruption Report (See Section 2.15(M) and Attachment D – Formulary Disruption Reporting)
· Drug Product Pricing Exclusions Form (S000000161 – Drug Product Pricing Exclusions.xlsx) (See Section 1.8(B).3.c.ii)
· Specialty Drug List (See Section 1.8(B).3.c.iii) It is strongly recommended that the following items are also included with the Prospective Contractor’s proposal:
· EO 98-04: Contract and Grant Disclosure Form
· Copy of Prospective Contractor’s Equal Opportunity Policy
· Voluntary Product Accessibility Template (VPAT), if applicable
· Signed addenda, if applicable
PROPOSED SUBCONTRACTORS FORM
· Do not include additional information relating to subcontractors on this form or as an attachment to this form.
· Prospective Contractor shall complete and submit the Proposed Subcontractors Form included in the Technical Proposal Packet.
· Additional subcontractor information may be required or requested in following sections of this RFP Solicitation or in the Information for Evaluation section provided in the Technical Proposal Packet. Do not attach any additional information to the Proposed Subcontractors Form.
· The utilization of any proposed subcontractor is subject to approval by the State agency.
PROSPECTIVE CONTRACTOR PROPOSES TO USE THE FOLLOWING SUBCONTRACTOR(S) TO PROVIDE SERVICES.
Type or Print the following information
| Subcontractor’s Company Name |
| Street Address |
| City, State, ZIP |
☐ PROSPECTIVE CONTRACTOR DOES NOT PROPOSE TO USE SUBCONTRACTORS TO PERFORM SERVICES.
Technical Proposal Packet Solicitation No. S000000161
INFORMATION FOR EVALUATION – EXPERIENCE: A [Maximum weighted Score Possible: 60 points]
Prospective Contractors should provide a response to each item/question in the section.
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses.
| 1 |
| Describe your experience with handling client-requested custom formularies. |
| 5 points |
| 2 |
| Describe your processes to partner with EBD’s clinical consultant to manage the formulary and the coupon/copay assistance program. List 3 current clients and their clinical consultant(s) with whom you have partnered with to manage formulary and rebates and/or a coupon/copay assistance program. For these 3 clients, provide a description of how you worked with the client and their clinical consultant(s), any challenges that hindered the partnership and how you resolved the issue. |
| 5 points |
| 3 |
| Describe how the Contractor directly contracts with at least ninety (90%) of its retail pharmacies that are part of its broad retail network. Describe how the Contractor will provide Transparent retail pricing that requires the amount billed to the Plan will be equal to the amount paid to the participating retail pharmacies with 100% pass through of all Rebates and pharmaceutical manufacturer revenue for the Plan that is fully verifiable and auditable. |
| 5 points |
| 4 |
| Describe the implementation and account management teams you propose to work with EBD. Include details on the team member’s years of experience in the industry and with your firm, the percentage of time each team member would dedicate to the account and who on the team would be 100% dedicated to EBD. |
| 5 points |
INFORMATION FOR EVALUATION – EXPERIENCE: b [Maximum weighted Score Possible: 20 points]
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses.
| 1 |
| What % of your book of business have custom formularies? |
| 5 points |
| 2 |
| Describe your experience working with individual group plans with approximately 130,000 covered lives (members plus dependents) and approximately 2.5 million annual scripts, including approximately 1.0 million annual scripts adjudicating at independent retail pharmacies. How many individual clients do you have with approximately 130,000 covered lives and approximately 1.0 million annual scripts adjudicating at independent retail pharmacies? |
| 5 points |
INFORMATION FOR EVALUATION – SOLUTION: A [Maximum weighted Score Possible: 165 points]
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses.
| 1 |
| Describe how the Contractor will allow EBD to customize the formulary, preferred drug list, and specialty formulary without any financial impact to the proposed discounts, dispensing fees, administrative fees, or Rebate guarantees. |
| 5 points |
| 2 |
| Describe how the Contractor will work with EBD and EBD’s clinical consultant to continue the process to ensure certain specified drugs are subject to step therapy, prior authorization, quantity duration limits, coverage limits, clinical programs, and safety monitoring as specified by EBD. |
| 5 points |
| 3 |
| Describe the Contractor’s pricing methodologies for the scenarios of matching the existing formulary and proposing Contractor’s optimized formulary. Specifically, describe how the pricing guarantees quoted as part of this solicitation will result in the lowest net cost to EBD. |
| 5 points |
| 4 |
| Describe your processes to minimize formulary disruption. Detail your formulary management services and how formulary exclusions are addressed. Also include in your response how and when you communicate any potential disruption to the members, their prescribing physicians, and the plan. Describe how the Contractor will allow EBD to reject the Contractor’s formulary changes without any financial impact to discounts, dispensing fees, administrative fees, or Rebate guarantees. |
| 5 points |
| 5 |
| Describe how the Contractor will allow EBD to customize the formulary, preferred drug list, and specialty formulary. Describe how Contractor will recommend quarterly, semi annual, and annual formulary changes to EBD. Describe the risks involved with EBD-proposed formulary edits which have negative rebate impacts. How will Contractor address these impacts, mitigate these impacts, and suggest alternatives to EBD? |
| 5 points |
| 6 |
| Describe how the Contractor will comply with the requirement not to remove from coverage brand or generic drug products from EBD's non-specialty formulary, specialty formulary, non-specialty drug listing, or specialty preferred drug listing without notification and prior approval from EBD, with the exception of FDA recalls or other safety issues. |
| 5 points |
| 7 |
| Describe how the Contractor will comply with the requirement not to add new drugs or line extensions to the Plan’s coverage until the new drug or line extension is reviewed and approved by EBD and EBD’s Clinical Consultants for purposes of determining formulary status and utilization management. |
| 5 points |
| 8 |
| Describe how EBD will have the right to remove a retail pharmacy from the broad retail pharmacy network and how the Contractor will comply with EBD’s request to remove the specified. Describe how EBD will have the right to remove a retail pharmacy from the Arkansas Independents & Associations retail pharmacy network and how the Contractor will comply with EBD’s removal of the specified retail pharmacy. |
| 5 points |
| 9 |
| Describe how the pricing guarantees (discounts, dispensing fees, and rebates) for each pricing channel (Retail 30, Retail 90, Mail Order, Specialty, and LDD) will not be contingent upon any day’s supply within each channel. |
| 5 points |
| 10 |
| Describe your financial reconciliation reporting and detail how it will include the contractual and actual discounts and dispensing fees for each pricing component on a separate component basis. Describe how the Contractor will agree to not offset any under-performance in a single pricing component with any over-performance in any other pricing component. |
| 5 points |
| 11 |
| Describe how the Contractor will distinguish Limited Distribution Drugs and Specialty Drugs. Confirm that Limited Distribution Specialty Drugs will adjudicate and reconcile with the Specialty Overall Effective Discount guarantees, Specialty dispensing fee guarantees, and Specialty Rebate guarantees. Confirm that non-Specialty Limited Distribution Drugs will adjudicate and reconcile with the non-Specialty Overall Effective Discount guarantees, non-Specialty dispensing fees, and non-Specialty rebate guarantees. |
| 5 points |
INFORMATION FOR EVALUATION – SOLUTION: B [Maximum weighted Score Possible: 70 points]
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses.
| 1 |
| Describe the clinical programs you propose for EBD and why you think those programs are appropriate for this client. Confirm that pricing is not contingent on participation in any proposed clinical management programs. |
| 5 points |
| 2 |
| Describe Contractor’s rebate processing and payment process. Describe how the Contractor will pay EBD the minimum Rebate guarantees and provide detailed reports listing the number of brand drugs per delivery channel within the ninety (90) days after the end of each quarter and will pay all shortfalls between the actual result and the guarantee to EBD within ninety (90) days of the end of each contractual year. |
| 5 points |
| 3 |
| Confirm and outline how you will comply with the Audit and Market Check Rights outlined in this RFP. |
| 5 points |
| 4 |
| Describe how the Contractor will ensure that members always pay the lowest price out of the member cost share, discounted ingredient cost plus dispensing fee, Maximum Allowable Cost (MAC), if applicable, and the Usual & Customary price. Describe how the Contractor will ensure members never pay a full copayment in instances where the Plan copay is greater than the discounted cost plus dispensing fee plus any sales taxes. |
| 5 points |
| 5 |
| Detail your methodology for calculating and adjudicating Limited Distribution Drugs, Biosimilars, House Generics, Brands, and DAW claims and how rebates for those drugs are handled. |
| 5 points |
| 6 |
| Describe how the Contractor will include formulary excluded brand products that were adjudicated as a result of an exception process such as for medical necessity in the discount, dispensing fee, minimum Rebate guarantees, and any Rebates associated with such drugs will be passed through at 100% to EBD. |
| 5 points |
| 7 |
| Prospective Contractors should explain any deviations, exceptions, or departures from the Definition of Terms Section (1.7) and identify any risks related to deviating from each definition and how the Prospective Contractor will mitigate these risks. |
| 5 points |
INFORMATION FOR EVALUATION – SOLUTION: C [Maximum weighted Score Possible: 25 points]
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses.
| 1 |
| Describe your PBM services and management capabilities. Describe why you think your PBM will best suit the unique needs of EBD. |
| 5 points |
| 2 |
| Describe how the all-inclusive Administrative fee will reflect the entire cost of complying with the requirements of this RFP and the entire cost of providing the services outlined in Section 1.10.B. |
| 5 points |
| 3 |
| Describe how the Contractor will provide standard reports to EBD within ten (10) business days of the end of the month, quarter, and year. Provide a sample quarterly and annual utilization reports. |
| 5 points |
| 4 |
| Describe how all applicable claims dispensed in all of the fifty (50) United States of America plus the District of Columbia will be included in the guarantees. |
| 5 points |
| 5 |
| What is your average turnaround time (TAT) to provide impact analyses for responding to formulary modification requests? |
| 5 points |
INFORMATION FOR EVALUATION – RISK [Maximum weighted Score Possible: 35 points]
Using this template, Prospective Contractors should address the risks of providing services outlined in the RFP that the Prospective Contractor does not control. The risks should be prioritized beginning with the greatest risks listed first.
Prospective Contractors may expand the space in each table, add a table, or delete a table as needed, but Prospective Contractors shall not exceed the two-page limit for this section.
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses on the Risk Assessment Plan document.
Prospective Contractors may delete the instructions above and the example shown below.
The Prospective Contractor’s Solution Response should include the following narrative response:
1. Describe the risks associated with EBD changing PBMs. Include in your response the effect such a change will have on the members and your processes to address these issues to provide the most seamless transition possible.
Example:
| Risk Description: |
| Participating Entity does not understand how to use the Commercial Card Program. |
| Solution: |
| A full-time training group will hold education meetings at all Participating Entity locations twice a year throughout the length of the contract. |
| Documented Performance: |
| This risk mitigation has been used on the last 4 clients and has received a 10/10 satisfaction rating. These four clients have reported 0 complaints from their constituents regarding the usage of their commercial card program. |
Risk Description:
Solution:
Documented Performance:
Risk Description:
Solution:
Documented Performance:
Risk Description:
Solution:
Documented Performance:
Risk Description:
Solution:
Documented Performance:
INFORMATION FOR EVALUATION – Recommended Options [Maximum weighted Score Possible: 0 points]
Using this template, Prospective Contractors should identify any value-add options or ideas relating to providing services as required in the RFP that may benefit the State. The Recommended Options should be prioritized beginning with the most impactful claims listed first.
Prospective Contractors may expand the space in each table, add a table, or delete a table as needed, but Prospective Contractors shall not exceed the two-page limit for this section.
Prospective Contractors shall not include the Prospective Contractor’s name or any other identifiers, including without limitation names of staff members, projects, products, and addresses on the Recommended Options Plan document.
Prospective Contractors may delete the instructions above and the example shown below.
Example:
| Item Claim: |
| 24/7 Customer Assistance |
| How will this add value? |
| Any time the client needs any type of commercial card support, they will have access to 24-hour customer support. |
| Documented Performance: |
| This support has been offered to our last 10 clients and has received a 10/10 satisfaction from these clients. Out of 4,000 service calls, more than 500 (12.5%) of them were received outside of regular service hours. |
| Cost Impact (%): |
| NA |
| Schedule Impact (%): |
| NA |
Item Claim:
How will this add value?
Documented Performance:
Cost Impact (%):
Schedule Impact (%):
Item Claim:
How will this add value?
Documented Performance:
Cost Impact (%):
Schedule Impact (%):
Item Claim:
How will this add value?
Documented Performance:
Cost Impact (%):
Schedule Impact (%):
Item Claim:
How will this add value?
Documented Performance:
Cost Impact (%):
Schedule Impact (%):
EXCEPTIONS FORM
Prospective Contractor shall document all exceptions related to requirements in the RFP Solicitation and terms in the “Standard Services Contract” and “Solicitation Terms and Conditions” located on the OSP website. See Section 1.12 and 1.13 of the RFP Solicitation.
| ITEM # |
| REFERENCE (SECTION, PAGE, PARAGRAPH) |
| DESCRIPTION |
| PROPOSED LANGUAGE |
1.
2.
3.
File details come from the government source that posted it. Updated .