T2679 Bid Amendment 6 02.05.2026 - Responses to QA and Update Quote Submission to 02.19.26~3.docx

MIKIE SHERRILL

Governor State of New Jersey

DEPARTMENT OF THE TREASURY

DIVISION OF PURCHASE AND PROPERTY

PROCUREMENT BUREAU

33 WEST STATE STREET

P. O. BOX 230

TRENTON, NEW JERSEY 08625-0230

AARON BINDER

Acting State Treasurer

DR. DALE G. CALDWELL

Lt. Governor

AMY F. DAVIS, ESQ.

Acting Director https://www.njstart.gov

February 5, 2026

To: All Interested Bidders

Re: Bid Solicitation # 25DPP01133 T2679 - Employee Benefits: Pharmacy Benefits Management

Previous Quote Submission Due Date: February 11, 2026 (2:00 p.m. Eastern Time) Revised Quote Submission Due Date: February 19, 2026 (2:00 p.m. Eastern Time)

Bid Amendment #6

The following constitutes Bid Amendment #6 to the above referenced Bid Solicitation:

· This Bid Amendment includes:

· Extension of the Quote Submission Due Date from February 11, 2026 to February 19, 2026 (2:00 p.m. Eastern Time).

· Answers to questions; and

· Revisions to the Bid Solicitation.

· Please note that for all additions, deletions, clarifications, and modifications to the Bid Solicitation, please refer to the Revised Bid Solicitation titled “T2679 Revised Bid Solicitation 02.05.2026” and hereafter referred to in this document as “Revised Bid Solicitation”. The following sections of the Revised Bid Solicitation include changes:

· Section 1.2, Background;

· Section 3.18, Mobilization Plan;

· Section 3.23, Experience with Contracts of a Similar Size and Scope;

· Section 3.25, Reverse Auction Tool Instructions;

· Section 4.1.3, Mail Order Pharmacy;

· Section 4.3.1.1, Drug Recall/Warning;

· Section 4.4.1 Account Management;

· Section 4.4.2.1, Customer Service Center;

· Section 4.5.3, Specific Requirements Related to the EGWP + WRAP Program;

· Section 4.6.1, Open Enrollment;

· Section 4.6.3, Technical Interface with State and Online Enrollment Vendor;

· Section 4.6.5, Coordination With SHBP/SEHBP Vendors;

· Section 4.6.6.2, Employer Group Waiver Plan Reporting;

· Section 4.6.6.4, Periodic Reporting (Quarterly and Annual);

· Section 4.7.1, Claims Administration;

· Section 4.9, Pass-Through Pricing;

· Section 4.9.1, Pass-Through Pricing Guarantees;

· Section 4.9.4, Pass-Through Pricing – Rebate Payments;

· Section 4.10, Implementation;

· Section 4.12, Claims Adjudication Review (CAR);

· Section 5.4, Liquidated Damages;

· Section 8.12, Reserved; and

· Section 9.3, Contract-Specific Definitions;

It is the sole responsibility of the Bidder to be knowledgeable of all of the additions, deletions, clarifications, and modifications to the Bid Solicitation and/or the New Jersey Standard Terms and Conditions relative to this Bid Solicitation as set forth in all Bid Amendments.

All other instructions, terms, and conditions of the Bid Solicitation shall remain the same.

Bid Solicitation #25DPP01133 T2679 - Employee Benefits: Pharmacy Benefits Management

Answers to Questions

Where applicable, each question references the appropriate Bid Solicitation section.

Note: These questions have been paraphrased in the interest of readability and clarity

Section Reference Question (Bolded) and Answer

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Please be advised that all Quotes shall be submitted electronically through NJSTART.

Should I check that I have properly completed and attached all of the required documents with my submitted Quote?

Yes. Prior to the Quote Opening Deadline, a Bidder should review the documents comprising the submitted Quote to ensure that all of the required documents have been completed and attached. Oftentimes a Quote is deemed non-responsive because a Bidder fails to attach a required form or attaches a blank form. To review a submitted a Quote, a Bidder should log into NJSTART and review each document attached to the Quote submission. Instructions on how to review a submitted Quote can be found in the Quick Reference Guide entitled How to Review a Submitted Quote, which is available on the NJSTART Vendor Support Page under Vendor Reference Guides.

As stated in Revised Bid Solicitation Section 2.2, Exceptions to the State of NJ Standard Terms and Conditions (SSTC): “Questions regarding the State of New Jersey Standard Terms and Conditions and exceptions to mandatory requirements MUST be posed during the Electronic Question and Answer period and shall contain the Bidder’s suggested changes and the reason(s) for the suggested change(s).”

Additionally, as stated in Revised Bid Solicitation Section 3.11, Bidder Additional Terms Submitted with the Quote: “Bidder proposed terms or conditions that conflict with those contained in the State of New Jersey Standard Terms and Conditions may render a Quote non-responsive.”

The State intends to issue the Notice of Intent to Award by June 2026, with the Contract effective for January 1, 2027. Please note the timeline is an estimate.

The State notes that the Quote Submission Due Date has been previously extended. If applicable, revisions to the Quote Submission Due Date will be posted per the discretion of the State, via Bid Amendment on NJSTART. Bidders are encouraged to refer to the Bid Solicitation and register their firm on NJSTART to receive all Bid Amendment updates.

Bidder proposed terms or conditions that conflict with those contained in the Bid Solicitation may render a Quote non-responsive. If a Bidder’s Quote is deemed to include material deviations from the terms, conditions, or requirements of the Bid Solicitation, that Quote will be deemed non-responsive and ineligible for further evaluation and potential award. Bidders that are responsive to all mandatory requirements of the Bid Solicitation and determined to be in the Competitive Range for the technical evaluation conducted by the Evaluation Committee will be considered eligible to participate in the reverse auction pricing process, subject to the completion of mandatory training.

The State does not accept the proposed modification. As stated in Revised Bid Solicitation Section 1.1, Purpose, and Intent and Background, the State may award any or all price lines. Only those services which correspond to awarded price lines will be included in the final Contract.

It is the State's intent to have these services reprocured to replace the existing contract for these services, which is currently set to expire on December 31, 2026.

Question 2 - What are the State's goals for the resulting contract?

The State’s goal, as stated in Revised Bid Solicitation Section 1.1, Purpose, and Intent and Background, is to award a Contractor that will administer all aspects of a Pharmacy Benefits Manager including, but not limited to, the processing of drug Claims, reporting, drug trending, and analysis for the State’s active employees and Retirees participating in the State Health Benefits Program/School Employees’ Health Benefits Program (SHBP/SEHBP).

The State declines to provide an evaluation of its current contractor as part of this Question and Answer Period.

Question 2 - In what areas is the State seeking improvement?

The State declines to provide an evaluation of its current contractor as part of this Question and Answer Period.

Yes, the incumbent of the current contract is the sole provider of all the listed services under Contract # 19-PROS1-00925.

Question 2 - Additionally, does the State intend to contract separately for any of the above services, a – g.?

No, the State does not intend to contract separately for any of the above services.

Yes, Plan Design Exhibit A is for open formulary.

Question 2 - If not, which of the plans are under an Open formulary?

For clarity, SEHBP NJ Direct/Aetna Freedom 10 and NJ Direct/Aetna Freedom 15 are open formulary (i.e. OptumRx Select).

Question 3 - How many total lives fall under an open formulary for active lives?

Approximately 30,000 total lives fall under an open formulary on the pharmacy benefit for active lives.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

Yes; however, exclusions are allowed only in specific instances to align with other policies (e.g. non-U.S. Food and Drug Administration [FDA] approved products).

Yes, Plan Design Exhibit B is for closed formulary.

Question 2 - For both SEHP and SHBP is the closed formulary the same?

Yes, the closed formulary is the same for both SEHP and SHBP.

A third party document would be any document from another entity which is included in the Bidder’s Quote and which includes terms and conditions that the Bidder does not have the authority to amend.

Please see Revised Bid Solicitation Section 3.11, Bidder Additional Terms Submitted With The Quote, for additional details.

Please note that any Bidder proposed terms or conditions that conflict with those contained in the Bid Solicitation and the State of New Jersey Standard Terms and Conditions will render a Quote non-responsive.

There are approximately 475,000 member lives for Commercial line of business, and approximately 230,000 member lives for EGWP line of business.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

The State cannot provide the requested data at this time. All relevant data will be made available in the Reverse Auction Tool and will be further explained in the mandatory training provided by the vendor for G3077 – Technical and Professional Services for Pharmacy Benefits Manager (PBM), as described in Revised Bid Solicitation Section 3.25, Reverse Auction Tool Instructions, in that format deemed most suitable by the vendor.

Relevant data will be made available in the Reverse Auction Tool and will be further explained in the mandatory training provided by the contractor for G3077 – Technical and Professional Services for Pharmacy Benefits manager (PBM), as described in Revised Bid Solicitation Section 3.25, Reverse Auction Tool Instructions.

Please refer to the answer for Question #18.

Bidders were required to sign and send Attachment 4 – T2679 Confidentiality/Non-Disclosure Disagreement (Attachment 4) prior to the close of the Electronic Question and Answer Period to receive the confidential documents. Upon the State’s receipt of T2679 Confidentiality/Non-Disclosure Agreement (Attachment 4), the confidential documents were then made available for Bidder review and provided via the State’s data exchange portal.

For the Question and Answer posting, if questions were received from Bidders prior to the close of the Question and Answer Period, answers to such questions will be posted by this Bid Amendment as a File Attachment on the “Summary” page and the “Attachments” tab of the Bid Solicitation and will become part of the Bid Solicitation and part of any Contract awarded as a result of the Bid Solicitation.

In accordance with Revised Bid Solicitation Section 2.3, Bid Amendments: Revisions to this Bid Solicitation: “There are no designated dates for release of Bid Amendments. Those Bidders who are on the bid holder list either through commodity code registration in NJSTART or by acknowledging the bid in NJSTART should receive notification of any Bid Amendment(s). If a Bidder is not on the bid holder list, Bid Amendments are still viewable on the “Summary” page of the Bid Solicitation in NJSTART.”

Please note, the State works to post answers as quickly as possible. However, if the process takes longer than expected due to the volume or complexity of the questions submitted, the State can and will push the Bid Opening date back to provide Bidders time after the answers have been posted to submit a Quote. If applicable, revisions to the Bid Opening date will be posted via Bid Amendment in NJSTART.

Please refer to the answer for Question #22.

Following execution of Attachment 4 by the State via the State’s data exchange portal, MOVEit, all Bidders who had submitted the attachment in accordance with Revised Bid Solicitation Section 2.6, Pre-Quote Document Review, were sent the confidential exhibits and the password for any of such confidential exhibits that were password protected. These firms must access the confidential exhibits via the MOVEit portal.

In addition, in accordance with Bid Amendment #2 of this Bid Solicitation, those firms that submitted a signed copy of ‘Attachment 4 - Confidentiality Non-Disclosure Agreement 10.31.25’ in accordance with Section 2.6 of the Bid Solicitation were sent the confidential exhibits following execution of Attachment 4 by the State via the State’s data exchange portal, MOVEit. These firms must access the confidential exhibits via the MOVEit portal.

As part of the MOVEit data exchange process, a password for any password protected confidential exhibits have been provided as part of the MOVEit submission to all firms with an executed Attachment 4.

No, the State is not placing a page limit for the Technical Quote.

As stated in Revised Bid Solicitation Section 1, Introduction and Summary of the Bid Solicitation: "Bidders are strongly encouraged to visit the NJSTART Vendor Support Page, which contains Quick Reference Guides (QRGs), supporting videos, a glossary of NJSTART terms, and helpdesk contact information. Bidders should utilize the QRGs before attempting to submit a Quote through NJSTART. It is the Bidder’s responsibility to ensure that the Quote and attachments have been properly submitted. Inquiries concerning the use of NJSTART may be directed to njstart@treas.nj.gov."

The Bidder checklist on NJSTART is specific to each Bid Solicitation and will be the same for all interested Bidders of any specific Bid Solicitation.

Question 2 - Additionally, do we need to resubmit forms that we have already submitted?

The State suggests submitting the completed form packets with all the forms and certifications. In Revised Bid Solicitation Section 3, Quote Submission Requirements, there are specific parts where forms need to be certified. Please do not rely on outdated forms from previous submissions for this procurement.

The Bidder’s Quote must be for all services required under the Bid Solicitation and Scope of Work. A Bidder’s Quote that is only for a portion of the services required by the Bid Solicitation and Scope of Work will be deemed non-responsive and ineligible for award.

Question 2 - If partial responses are permitted, how should this be indicated in the submission?

See above.

Please reference Revised Bid Solicitation Section 3.12, Quote Content which states: “The Quote should be submitted with the attachments organized in the following manner:

· Forms

· Technical Quote

· State of New Jersey Security Due Diligence Third Party Information Security Questionnaire”

Please refer to Revised Bid Solicitation Section 3, Quote Submission Requirements, for a complete listing of Quote submission requirements. It is noted that Exhibits A through N are for informational purposes, and do not need to be submitted as part of the Quote by the Bidder.

There is no preferred naming convention or file format for uploaded documents; however, please refer to the ‘Attaching Forms and Files’ link under ‘Vendor Profile Management’ in the NJSTART Vendor Support Page’s Quick Reference Guides to view those file formats not accepted in NJSTART.

Bidders may submit the referenced items as part of the Quote, but are not required to. If not submitted with the Quote, the Bidder will be required to comply with the State’s requirements prior to Contract award.

Yes. Bidders are instructed to refer to the ‘Submit a Quote’ link under ‘Vendor Bidding Opportunities’ in the NJSTART Vendor Support Page’s Quick Reference Guides.

Bidders are encouraged to complete the Source Disclosure Form as stated in Revised Bid Solicitation Section 3.13.6, Service Performance within the United States, for consideration.

Bidders are urged to refer to the New Jersey Open Public Records Act (OPRA), N.J.S.A. 47:1A-1 et seq. Certain financial information may be considered confidential, however the State cannot make any confirmations or guarantees with regard to hypothetical information. Bidders must complete and submit their signed and completed Confidentiality and Commitment to Defend Form, as described in Revised Bid Solicitation Section 3.13.7, Confidentiality/Commitment to Defend, with the relevant information to be held confidential.

The State does not accept the proposed modifications.

In accordance with Revised Bid Solicitation Section 9.2, Definitions, a Subcontractor is defined as any “entity having an arrangement with a Contractor, whereby the Contractor uses the products and/or services of that entity to fulfill some of its obligations under its State Contract…” As such any Subcontractor must have a valid Business Registration Certificate (BRC) issued by the Department of Treasury, Division of Revenue and Enterprise Services (DORES), as stated in Revised Bid Solicitation Section 3.13.13, Business Registration.

“The Bidder shall describe its approach and plans for accomplishing the work outlined in the Scope of Work. The Bidder must set forth its understanding of the requirements of this Bid Solicitation and its approach to successfully complete the Contract. The Bidder should include the level of detail it determines necessary to assist the Evaluation Committee in its review of the Bidder’s Quote.”

Revised Bid Solicitation Section 3.15, Management Overview, states that:

“The Bidder shall set forth its overall technical approach and plans to meet the requirements of the Bid Solicitation in a narrative format. This narrative should demonstrate to the Evaluation Committee that the Bidder understands the objectives that the Contract is intended to meet, the nature of the required work, and the level of effort necessary to successfully complete the Contract. The narrative should demonstrate that the Bidder’s approach and plans to undertake and complete the Contract are appropriate to the tasks and subtasks involved.

Mere reiterations of Bid Solicitation tasks and subtasks are strongly discouraged, as they do not provide insight into the Bidder’s approach to complete the Contract. The Bidder’s response to this section should demonstrate to the Evaluation Committee that the Bidder’s detailed plans and approach proposed to complete the Scope of Work are realistic, attainable and appropriate, and that the Bidder’s Quote will lead to successful Contract completion.”

The Bidder is to submit a narrative detailing how it intends to accomplish the requirements and tasks outlined in the Scope of Work i.e. approaches, plans, processes, frameworks, etc. Bidders should provide explanations as opposed to simply restating the Bid Solicitation requirements, detailing how they will perform all duties as required.

Please refer to each respective section for specific requirements and instructions.

Bidders are instructed to refer to the ‘Submit a Quote’ link under ‘Vendor Bidding Opportunities’ in the NJSTART Vendor Support Page’s Quick Reference Guides.

In accordance with Revised Bid Solicitation Section 3.15, Management Overview, states that: “The Bidder shall set forth its overall technical approach and plans to meet the requirements of the Bid Solicitation in a narrative format. This narrative should demonstrate to the Evaluation Committee that the Bidder understands the objectives that the Contract is intended to meet, the nature of the required work, and the level of effort necessary to successfully complete the Contract. The narrative should demonstrate that the Bidder’s approach and plans to undertake and complete the Contract are appropriate to the tasks and subtasks involved.”

“Mere reiterations of Bid Solicitation tasks and subtasks are strongly discouraged, as they do not provide insight into the Bidder’s approach to complete the Contract. The Bidder’s response to this section should demonstrate to the Evaluation Committee that the Bidder’s detailed plans and approach proposed to complete the Scope of Work are realistic, attainable and appropriate, and that the Bidder’s Quote will lead to successful Contract completion.”

The State intends to award and then implement the Contract resulting from this Bid Solicitation so that full services may commence on January 1, 2027.

The State intends to award and then implement the Contract resulting from this Bid Solicitation so that full services may commence on January 1, 2027.

Bidders are to include any key dates listed throughout the Scope of Work as part of their Contract Schedule, as required by Revised Bid Solicitation Section 3.17, Contract Schedule, and illustrate how they intend to meet these specific dates and note what deliverable will be submitted at the end of each task and/or subtask.

Yes, the State will accept these biographies in lieu of resumes; however, the State reserves the right to evaluate and score accordingly based on information which is included and/or omitted.

No, the State will not waive this request. To clarify, Revised Bid Solicitation Section 3.22(D) requests references be provided for “each similar Contract” that the individual states to have previously worked on. The section does not request personal references. Note that this section is labeled as a ‘should’ and is not required to be submitted with the Bidder’s Quote. Failure to provide this requested information will not disqualify a Bidder from award, though it may impact a Bidder’s evaluation score.

Designated as a should, these resumes are not required, and the Bidder may supply an overview in lieu of the resumes; however, doing so may impact the Bidder’s technical score with the Evaluation Committee.

Please refer to the answer for Question #44.

Question 2 - Can we include information regarding Subcontractor experience serving public sector clients in lieu of the request to submit "resumes?"

Please refer to the answer for Question #44.

Ultimately, it is the responsibility of the Bidder to identify its key personnel as part of its Quote, but yes, the State would consider the Account Management Team identified in Revised Bid Solicitation Section 4.4.1.1, Account Management Team, to be key personnel under this Bid Solicitation.

The State will evaluate how each Bidder meets the experience outlined in Revised Bid Solicitation Section 3.23, Experience with Contracts of Similar Size and Scope. The State notes that the experience requirements outlined in Section 3.23 are a “should”, and while not meeting the experience specified may not lead to automatic disqualification, it may impact a Bidder’s technical score. Please refer to Revised Bid Section 3.23, Experience with Contracts of Similar Size and Scope, for additional information, as this section has been revised.

The Bidder must be able to meet the requirements of Revised Bid Solicitation Section 4.5.3, Specific Requirements Related to the EGWP + WRAP Program.

The State agrees to modify the specified experience to at least 14,000 Medicare-eligible Retiree lives.

Please refer to Revised Bid Solicitation Section 3.23, Experience with Contracts of Similar Size and Scope, for additional information, as this section has been revised.

Yes, it is acceptable for the incumbent Contractor to use its work with the State as a reference to meet the request made in Revised Bid Solicitation Section 3.23, Experience with Contracts of a Similar Size and Scope.

As stated in Revised Bid Solicitation 3.24, Financial Capability of the Bidder: “In order to provide the State with the ability to evaluate the Bidder’s financial capacity and capability to undertake and successfully complete the Contract, the Bidder should submit the following:

A. For publicly traded companies the Bidder should provide copies or the electronic location of the annual reports filed for the two most recent years; or B. For privately held companies the Bidder should provide the certified financial statement (audited or reviewed) in accordance with applicable standards by an independent Certified Public Accountant, including a balance sheet, income statement, and statement of cash flow, and all applicable notes for the most recent calendar year or the Bidder’s most recent fiscal year.

The Bidder should provide sufficient financial information with its Quote to enable the State to assess the financial strength and creditworthiness of the Bidder and its ability to undertake and successfully complete the Contract.

A Bidder may designate specific financial information as not subject to disclosure when the Bidder has a good faith legal/factual basis for such assertion. The State reserves the right to make the determination to accept the assertion and will so advise the Bidder.

If the information is not supplied with the Quote, the State may still require the Bidder to submit it. If the Bidder fails to comply with the request within seven (7) Business Days, the State may deem the Quote non-responsive.”

All Bidders are required to provide six (6) years of pricing, covering four (4) base-Contract years with two (2) 1-year extensions available to the State. All years will be evaluated with a primary focus on the 4-year pricing.

All Defined Exclusions should be selected to align with the terms of the Bid Solicitation. In addition, Bidders can upload additional exclusions in the "Rebates Exclusion Custom" section to reflect additional categories. Pricing exclusions should be selected in alignment with the requirements of the Bid Solicitation.

Pricing exclusions should be selected in alignment with the requirements of the Bid Solicitation.

As stated in Revised Bid Solicitation Section 3.25, Reverse Auction Tool Instructions, access to the Reverse Auction Tool will be established by the contractor of G3077 – Technical and Professional Services for Pharmacy Benefits Manager (PBM), on a date specified by the State.”

The State is unable to commit to any specific timeline for the commencement of the reverse auction phase. The State anticipates that the reverse auction will begin shortly after the State determines the Qualified Bidders.

As stated in Revised Bid Solicitation Section 4.1.3.G, Mail Order Pharmacy, the Contractor shall “apply the Lowest of Pricing Logic for all Mail Order Pharmacy Covered Items, regardless of pricing model (for example: NADAC, MAC, Average Wholesale Price [AWP])”.

The Average Cost Guarantees are reconciled semi-annually. Please refer to Revised Bid Solicitation Section 9.3, Contract-Specific Definitions, for additional information, as this section has been revised.

Pricing will be further clarified during the reverse auction phase of the procurement.

The State will accept the Bidder’s most competitive pricing that would be in the best interest of the State and is compliant with pass-through provisions of the Bid Solicitation. The Bidder can submit pricing based on a cost-plus framework grounded in National Average Drug Acquisition Cost (NADAC), as long as this basis is used consistently in the submission.

The State does not accept the proposed modification.

In 2025, paper claims totaled 325 for Commercial and 509 for EGWP.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

The State utilizes a third party vendor for enrollment with eligibility files transferred to the PBM.

Question 2 - Please clarify the State's EGWP enrollment process.

Please refer to Revised Bid Solicitation Section 7.5, Compliance with Law, as, per federal law, members are eligible to enroll as is consistent with the Center for Medicare Services’ (CMS’s) approved Medicare Part D Plan, also known as a Series 800 Plan.

The State receives member premiums and factors such financial processing along with additional revenue streams (i.e. federal subsidies). Further information about EGWP can be found from CMS here: https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/employer-group-waiver-plans-egwps.

Question 2 - How are premiums collected and accounted for by the State's current PBM?

The State understands this question as asking whether or not the PBM is responsible for the collection of Member premiums. No, the PBM is not responsible for such a collection. The State collects Member premiums from a payroll reduction for use of the paying Contractor on an invoice basis.

As of Q3 2025, the State carries approximately 475,000 Commercial and 230,000 EGWP lives on the pharmacy benefit.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

Yes, the State confirms the above quantities.

Bidders should submit their proposal for most competitive offering. The Reverse Auction Tool will include instructions on how to include the preferred components for each line of business (i.e. Commercial and EGWP). For Bidder awareness, the current contract offers an exclusive arrangement on Commercial and is open on the EGWP population.

The State does not allow offsetting as part of reconciliation.

No. Only retirees enrolled in Medicare are enrolled in EGWP.

No, there are no Retirees considered retiree drug subsidy (RDS) members.

The breakdown of approximate annual total prior authorizations for 2024 is as follows:

· 163,000 for Commercial; and

· 56,000 for EGWP.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

There are approximately 15,500 appeals annually.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

There are approximately 1,000 grievances annually.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

There are approximately 1,500 Direct Member Reimbursements (DMRs) annually.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.