T3110 Bid Solicitation 10.14.25.docx

Bid Solicitation #

26DPP01218

T3110 Medical and Pharmacy Claims Reviewer, Data Management and Technical Services

Due Date For Electronic Questions Refer to Bid Solicitation Section 2.1 for more information.

Optional Pre-Quote Submission Conference Refer to Bid Solicitation Section 2.5 for more information.

Site Visit Refer to Bid Solicitation Section 2.4 for more information.

Not Applicable

Quote Opening Date Refer to Bid Solicitation Section 3 for more information.

Dates are subject to change. All times contained in the Bid Solicitation refer to Eastern Time.

All changes will be reflected in Bid Amendments to the Bid Solicitation posted on www.njstart.gov.

SET-ASIDES

Small Business Set-Aside For Goods and Services:

☒ I ☒ II ☒ III

For Construction:

☐ IV ☐ V ☐ VI

☐ Not Applicable ☐ Entire Contract ☐ Partial Contract ☒ Subcontracting Only ☐ Preference

☐ Entire Contract ☐ Partial Contract ☐ Subcontracting Only ☐ Preference

Bid Solicitation Issued By:

State of New Jersey Department of the Treasury Division of Purchase and Property Trenton, New Jersey 08625‑0230 On Behalf of:

State of New Jersey Department of the Treasury Division of Pensions and Benefits Trenton, NJ 08625-0295

Date: 10/14/2025

TABLE OF CONTENTS

ATTACHMENT 1 – Combined State of New Jersey Standard Terms and Conditions (6/3/2025) ATTACHMENT 2 – Bid Solicitation Checklist ATTACHMENT 3 – State-Supplied Price Sheet ATTACHMENT 4 – State of New Jersey Security Due Diligence Third-Party Information Security Questionnaire

INTRODUCTION AND SUMMARY OF THE BID SOLICITATION

This Bid Solicitation is issued by the Department of the Treasury, Division of Purchase and Property (Division), Procurement Bureau, on behalf of Department of Treasury, Division of Pensions and Benefits (DPB), as administrator for the State Health Benefits Commission and the School Employees’ Health Benefits Commission (Commissions). Quotes submitted in response to this Bid Solicitation shall be through the State of New Jersey’s eProcurement system, NJSTART. Bidders are advised to thoroughly read all sections of this Bid Solicitation and follow all instructions.

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 Division will not respond to substantive questions related to the Bid Solicitation or any other Contract via this email address.

PURPOSE AND INTENT

The purpose of this Bid Solicitation is to solicit Quotes from qualified Bidders to provide both Scope 1, Medical Claims Reviewer and Data Management Services, and Scope 2, Pharmacy Claims Reviewer and Technical Services, as specified in Section 4 of this Bid Solicitation.

To accomplish these goals outlined in Section 4 of this Bid Solicitation, Section 4 is divided into two (2) parts, Scope 1 and Scope 2. Scope 1 seeks Quotes from qualified Contractors to provide medical Claims review and data management services and Scope 2 seeks pharmacy benefits Claims review and technical/professional support to DPB’s Pharmacy Benefits Manager (PBM) contract.

Bidders have the option to respond to:

· Scope 1 – Medical Claims Reviewer and Data Management Services (Bid Solicitation Sections 4.1); or

· Scope 2 – Pharmacy Claims Reviewer and Technical Services (Bid Solicitation Section 4.6); or

· Both Scope 1 and Scope 2

It is the intent of the State of New Jersey (State) to award one or more Contracts to the responsible Bidder(s) whose Quote(s), conforming to this Bid Solicitation, are most advantageous to the State, price and other factors considered. The State may award any or all price lines. Pursuant to Bid Solicitation Section 3.14 Technical Quote, Bids that include subcontracting to perform tasks within the scope of this RFP must include details on the proposed Subcontractor and the price lines their work will address. The State reserves the right to separately procure individual requirements that are the subject of the Contract during the Contract term, when deemed by the Director of the Division (Director) to be in the State’s best interest.

The State of New Jersey Standard Terms and Conditions (SSTCs) included with this Bid Solicitation will apply to all Contracts made with the State. These terms are in addition to the terms and conditions set forth in this Bid Solicitation and should be read in conjunction with them unless the Bid Solicitation specifically indicates otherwise.

NATURE OF THE SHBC/SEHBC PROGRAM AND POSSIBLE PLAN DESIGN CHANGES

Public Law 2011, Chapter 78 (Chapter 78), created the State Health Benefits Plan Design Committee and the School Employees’ Health Benefits Plan Design Committee (the Plan Design Committees), which are responsible for reviewing the SHBP and SEHBP plan designs, respectively, and developing any changes therein that are determined to be cost effective and in the mutual best interests of the State, participating Local Employers, Employees, Retirees, and their Dependents.

BACKGROUND

This is a reprocurement of the services under T3110 Medical Claims Reviewer and Data Management Services and G3077 Pharmacy Benefits Claims Reviewer and Technical Services. This procurement combines the services previously provided under those separate contracts.

Bidders interested in reviewing the expiring Contract specifications and pricing information may do so by following the instruction below. Bidders should not rely upon or use data or information from the expiring Contracts when preparing a response to this Bid Solicitation as this Bid Solicitation addresses the State’s current requirements.

· Go to: www.njstart.gov

· In the search bar, select “Contracts” from the drop down menu

· Enter T3110 or G3077 and click “”

· The expiring Contract list will appear under “Results”

BACKGROUND ON THE SHBP AND SEHBP

The State Health Benefits Program (SHBP) was created in 1961 by the NJ State Health Benefits Program Act, N.J.S.A. 52:14-17.25 et seq., to provide health insurance coverage to State Employees. The School Employees’ Health Benefits Program (SEHBP) was established in 2007 by the School Employees’ Health Benefits Program Act, N.J.S.A. 52:14-17.46.1 et seq., to provide health coverage to qualified Local Education Employees, Retirees, and eligible Dependents.

The SHBP/SEHBP covers State Employees and Retirees, as well as Employees and Retirees of Local Government and Education Employers who have elected to purchase coverage in the SHBP/SEHBP. Presently, the SHBP/SEHBP covers approximately 770,000 lives (including active, retired and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) individuals and their Dependents) which equates to approximately 15 million medical Claims per year. Approximately 230,000 of the retired lives are enrolled in Medicare.

P.L. 2019, CHAPTER 143

This Bid Solicitation is issued in accordance with Public Law 2019, Chapter 143, which may be viewed at https://www.njleg.state.nj.us/2018/Bills/PL19/143_.PDF. This law requires the procurement of a third-party Medical Claims Reviewer to provide ongoing review and oversight of current medical Claims processes. In addition, the Medical Claims Reviewer also must collect, store and maintain a secure archive of medical and prescription drug Claims and other health services payment information, as well as document the cost and nature of Claims incurred, demographic information on the covered population, emerging utilization and demographic trends. It should be noted that the selected Contractor(s) shall not be the carrier, subsidiary, related party, or affiliate thereof, with which the State has contracted pursuant to section 4 of P.L. 1961, c. 49 (N.J.S.A. 52:14-17.28) or section 35 of P.L. 2007, c.103 (N.J.S.A. 52:14-17.46.5) for the provision of hospital, surgical, obstetrical, and other covered health care services and benefits for the Provider networks for those services. The Medical Claims Reviewer shall not exercise any authority over the provision of health care benefits for Medicare-eligible Retirees.

P.L. 2016, CHAPTER 67

This Bid Solicitation is issued in accordance with Public Law 2016, Chapter 67, which may be viewed at https://pub.njleg.state.nj.us/bills/2016/pl16/67_.pdf. This law requires the procurement of a third-party Pharmacy Claims Reviewer to provide ongoing review and oversight of current pharmacy Claims processes. Specifically, real-time, electronic, line-by-line, Claim-by-Claim review of invoiced Pharmacy Benefits Manager pharmacy Claims using an Automated Claims Adjudication Technology Platform that allows for online comparison of Pharmacy Benefits Manager Invoices and auditing of other aspects of the services provided by the Pharmacy Benefits Manager. The relevant act shall expire upon the award of the next Pharmacy Benefits Manager contract.

CONTRACT AMOUNT

The estimated amount of the Contract, if stated, shall not be construed as either the maximum or minimum amount which the State shall be obliged to order.

ORDER OF PRECEDENCE OF CONTRACTUAL TERMS

The Contract awarded, and the entire agreement between the parties, as a result of this Bid Solicitation shall consist of: (1) the final Bid Solicitation, (2) the State of New Jersey Standard Terms and Conditions, (3) the Quote, and if applicable (4) any Bidder responses to clarifications; (5) a Bidder’s Best and Final Offer, (6) other negotiated document, and/or (7) third-party document. In the event of a conflict in the terms and conditions among the documents comprising this Contract, the order of precedence, for purposes of interpretation thereof, shall be as listed from highest ranking to lowest ranking as noted above.

Any other terms or conditions, not included with the Bidder’s Quote and accepted by the State, shall not be incorporated into the Contract awarded. Any references to external documentation, including those documents referenced by a URL, including without limitation, technical reference manuals, technical support policies, copyright notices, additional license terms, etc., are subject to the terms and conditions of the Bid Solicitation and the State of New Jersey Standard Terms and Conditions. In the event of any conflict between the terms of a document incorporated by reference, the terms and conditions of the Bid Solicitation and the State of New Jersey Standard Terms and Conditions shall prevail.

INTRASTATE COOPERATIVE PURCHASING

NOT APPLICABLE TO THIS PROCUREMENT

PRE-QUOTE SUBMISSION INFORMATION

The Bidder assumes sole responsibility for the complete effort required in submitting a Quote and for reviewing the Quote submission requirements and the Scope of Work requirements.

ELECTRONIC QUESTION AND ANSWER PERIOD

The Division will electronically accept questions and inquiries from all potential Bidders via the “Q&A” Tab of the Bid Solicitation in NJSTART. Questions should be directly tied to a Bid Solicitation Section, the State-Supplied Price Sheet, Form or Attachment; and should reference the specific Bid Solicitation Section or document to which it relates.

The cut-off date for electronic questions and inquiries relating to this Bid Solicitation is indicated on the Bid Solicitation cover page. In the event that questions are posed by Bidders, answers to such questions will be issued by Bid Amendment.

A Bidder shall not contact the Using Agency and/or the Procurement Specialist directly, in person, by telephone or by e-mail, concerning this Bid Solicitation, prior to Contract award.

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).

BID AMENDMENTS

In the event that it becomes necessary to clarify or revise this Bid Solicitation, such clarification or revision will be by Bid Amendment. Any Bid Amendment will become part of this Bid Solicitation and part of any Contract awarded. Bid Amendments will be posted as a file attachment on the “Summary” page of the Bid Solicitation in NJSTART after the cut-off date.

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.

It is the sole responsibility of the Bidder to be knowledgeable of all Bid Amendments related to this procurement. An interested Bidder should check the NJSTART “Open Bids” Tab on a daily basis to ensure review of the most updated information.

SITE VISIT

NOT APPLICABLE TO THIS PROCUREMENT

OPTIONAL PRE-QUOTE CONFERENCE

The date and time of the Optional Pre-Quote Conference is indicated on the Bid Solicitation cover sheet. Attendees may attend the Optional Pre-Quote Conference with the following video conference and/or call-in details:

Microsoft Teams Join on your computer or mobile app Click here to join the meeting now Meeting ID: 249 103 767 706 Passcode: yB7UT2BH

Or dial in by phone +1 856-338-7074,,862955270# United States, Camden Find a local number Phone conference ID: 862 955 270#

The Optional Pre-Quote Conference may be recorded.

The purpose of the Optional Pre-Quote Conference is to address procedural questions regarding the Bid Solicitation and Bidder Quote Submission Requirements only. No substantive questions regarding the Bid Solicitation Scope of Work will be accepted or answered during the pre-Quote conference. All questions are to be submitted during the Electronic Question and Answer Period.

PRE-QUOTE DOCUMENT REVIEW

NOT APPLICABLE TO THIS PROCUREMENT

QUOTE SUBMISSION REQUIREMENTS

QUOTE SUBMISSION

In order to be considered for award, the Quote must be received electronically by the Division’s Proposal Review Unit, through NJSTART, by the required date and time.

The date and time of the Quote opening are indicated on the Bid Solicitation cover sheet and on the “Summary” Tab of the Bid Solicitation webpage within NJSTART. If the Quote opening deadline has been revised, the new Quote opening deadline will be shown on the posted Bid Amendment and on the “Summary” Tab of the Bid Solicitation webpage within NJSTART. Quotes not received prior to the Quote opening deadline shall be rejected.

Quotes will be publicly opened and announced by telephone conference on the date and time of the quote opening.

(Dial-in phone number: 888-204-5984 / Access code: 2602305)

When submitting a Quote through NJSTART, do not use any symbols (i.e., #, @, $, &, *) in the filename as this may prevent the Quote from being properly uploaded. Uploaded files must be compatible with Microsoft Office and/or Adobe software applications. DO NOT UPLOAD files with extensions such as .zip, .numbers, or .pages.

When uploading the documents to NJSTART, the Bidder should select the “Confidential” option in NJSTART for attachments on the “Attachments” Tab to request that the documents not be displayed publicly through NJSTART. Marking an attachment as "Confidential" in NJSTART shall not constitute the Bidder's designation of the attachment as exempt from public disclosure under the New Jersey Open Public Records Act (OPRA), N.J.S.A. 47:1A-1 et seq., or the common law right to know.

BIDDER RESPONSIBILITY

The Bidder assumes sole responsibility for the complete effort required in submitting a Quote in response to this Bid Solicitation. No special consideration will be given after Quotes are opened because of a Bidder’s failure to be knowledgeable as to all of the requirements of this Bid Solicitation. The State assumes no responsibility and bears no liability for costs incurred by a Bidder in the preparation and submittal of a Quote in response to this Bid Solicitation or any pre-contract award costs incurred.

ANNOUNCEMENT OF QUOTE INFORMATION

On the date and time Quotes are due under the Bid Solicitation, all information concerning the Quotes submitted may be publicly announced and shall be available for inspection and copying except otherwise noted:

A. Information appropriately designated as proprietary and/or confidential in a Bidder’s Quote shall not be available for inspection and copying; and B. Where negotiation is contemplated, only the names and addresses of the Bidders submitting Quotes will be announced, and the contents of the Quotes shall not be available for inspection and copying until the Notice of Intent to Award is issued by the Director.

QUOTE ERRORS

In accordance with N.J.A.C. 17:12-2.11 “Proposal errors,” a Bidder may withdraw its Quote as described below.

QUOTE WITHDRAWAL PRIOR TO QUOTE OPENING

A Bidder may withdraw its Quote submission in NJSTART prior to the Quote opening; however, Bidders should note that while withdrawn NJSTART Quotes remain viewable by the Bidder on its Vendor Profile Homepage, they are removed from the Division’s view and cannot be considered for Contract award. The Bidder may submit a revised Quote as long as the Quote is received prior to the announced date and time for Quote submission. Bidders may refer to the QRG “Submit a Quote” for additional instructions.

QUOTE WITHDRAWAL AFTER QUOTE OPENING, BUT PRIOR TO CONTRACT AWARD

If, after the Quote opening, but before Contract award, a Bidder discovers an error in its Quote, the Bidder may make a written request to the Procurement Bureau to withdraw its Quote, or a portion thereof, from consideration for award. If the Bidder’s request to withdraw is made in good faith, and the State will not be significantly prejudiced by granting the withdrawal of the Quote beyond the loss of the benefit of the bargain to the State of the withdrawing Bidder’s offer, the request shall be granted. Evidence of the Bidder’s good faith in making this request can be demonstrated by one (1) or more of the following factors: A mistake is so significant that to enforce the Contract resulting from the Quote would be unconscionable; that the mistake relates to a material feature or term of the Contract; and that the mistake occurred notwithstanding the Bidder’s exercise of reasonable care. After Quote opening, while pursuant to the provisions of this section a Bidder may request to withdraw its Quote and the Director may in his/her discretion allow said Bidder to withdraw it, the Division also may take notice of repeated or unusual requests to withdraw by a Bidder and take those prior requests to withdraw into consideration when evaluating the Bidder’s future Quotes.

The Quote withdrawal request must include the Bid Solicitation Number, Bid Solicitation Title, and the Quote submission date and should be sent to Procurement.Bureau@treas.nj.gov.

If, during a Quote evaluation process, an obvious pricing error made by a potential Contract awardee is found, the Director or his/her designee shall issue written notice to the Bidder. The Bidder will have up to five (5) Business Days after receipt of the notice to confirm its pricing. If the Bidder fails to respond, its Quote shall be considered withdrawn, and no further consideration shall be given to it.

JOINT VENTURE

If a Joint Venture is submitting a Quote, the agreement between the parties relating to such Joint Venture should be submitted with the Joint Venture’s Quote. Authorized signatories from each party comprising the Joint Venture must sign the Offer and Acceptance Page. Each party to the Joint Venture must individually complete and comply with all the forms and certification requirements in Bid Solicitation Section 3 – Quote Submission Requirements.

SMALL BUSINESS SET-ASIDE CONTRACTS

NOT APPLICABLE TO THIS PROCUREMENT

DISABLED VETERANS’ BUSINESS SET-ASIDE CONTRACT

NOT APPLICABLE TO THIS PROCUREMENT

BID SECURITY

NOT APPLICABLE TO THIS PROCUREMENT

BIDDER ADDITIONAL TERMS SUBMITTED WITH THE QUOTE

A Bidder may submit additional terms as part of its Quote. Additional terms are Bidder-proposed terms or conditions that do not conflict with the scope of work required in this Bid Solicitation, the terms and conditions of this Bid Solicitation, or the State of New Jersey Standard Terms and Conditions. Bidder proposed terms or conditions that conflict with those contained in the State of New Jersey Standard Terms and Conditions will render a Quote non-responsive. It is incumbent upon the Bidder to identify and remove its conflicting proposed terms and conditions prior to Quote submission.

Quotes including Bidder proposed additional terms may be accepted, rejected, or negotiated, in whole or in part, at the State’s sole discretion.

If Bidder intends to propose terms and conditions that conflict with the State of New Jersey Standard Terms and Conditions, those Bidder proposed terms and conditions shall only be considered if submitted and agreed to pursuant to the electronic question and answer procedure. Bidders shall not submit exceptions or modifications as part of the Quote or on the “Terms and Conditions” Tab through NJSTART.

QUOTE CONTENT

The Quote should be submitted with the attachments organized in the following manner:

1. Forms

2. Technical Quote

3. State-Supplied Price Sheet

4. State of New Jersey Security Due Diligence Third-Party Information Security Questionnaire

A Bidder should not password protect any submitted documents. Use of URLs in a Quote should be kept to a minimum and shall not be used to satisfy any material term of a Bid Solicitation. If a preprinted or other document included as part of the Quote contains a URL, a printed copy of the information should be provided and will be considered as part of the Quote.

FORMS, REGISTRATIONS AND CERTIFICATIONS TO BE SUBMITTED WITH QUOTE

A Bidder is required to complete and submit the following forms. As an alternative to uploading certain forms with the submitted Quote, a Bidder may complete several certifications electronically in NJSTART on the “Terms and Categories” Tab within the Vendor Profile. Those forms that may be completed on the NJSTART “Terms and Categories” Tab are noted below. Additionally, a Bidder may attach completed forms to the Vendor Profile. Refer to QRGs “Vendor Forms” and “Attaching Files” for additional instructions. VENDOR QUICK REFERENCE GUIDES

OFFER AND ACCEPTANCE PAGE

The Bidder should complete and submit the Offer and Acceptance Page with the Quote. The Offer and Acceptance Page must be signed by an authorized representative of the Bidder. If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

OWNERSHIP DISCLOSURE FORM

Pursuant to N.J.S.A. 52:25-24.2, in the event the Bidder is a corporation, partnership or limited liability company, the Bidder must disclose all 10% or greater owners by (a) completing and submitting the Ownership Disclosure Form with the Quote; (b) if the Bidder has submitted a signed and accurate Ownership Disclosure Form dated and received no more than six (6) months prior to the Quote submission deadline for this procurement, the Division may rely upon that form; however, if there has been a change in ownership within the last six (6) months, a new Ownership Disclosure Form must be completed, signed and submitted with the Quote; or, (c) a Bidder with any direct or indirect parent entity which is publicly traded may submit the name and address of each publicly traded entity and the name and address of each person that holds a 10 percent or greater beneficial interest in the publicly traded entity as of the last annual filing with the federal Securities and Exchange Commission or the foreign equivalent, and, if there is any person that holds a 10 percent or greater beneficial interest, also shall submit links to the websites containing the last annual filings with the federal Securities and Exchange Commission or the foreign equivalent and the relevant page numbers of the filings that contain the information on each person that holds a 10 percent or greater beneficial interest. N.J.S.A. 52:25-24.2.

NOTE: In lieu of completing and submitting the paper-based form, the Bidder has the option to complete this form online in NJSTART on the “Terms and Categories” Tab.

A Bidder’s failure to submit the information required by N.J.S.A. 52:25-24.2 will result in the rejection of the Quote as non-responsive and preclude the award of a Contract to said Bidder.

DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM

The Bidder should submit Disclosure of Investment Activities in Iran form to certify that, pursuant to N.J.S.A. 52:32-58, neither the Bidder, nor one (1) of its parents, subsidiaries, and/or affiliates (as defined in N.J.S.A. 52:32-56(e)(3)), is listed on the Department of the Treasury’s List of Persons or Entities Engaging in Prohibited Investment Activities in Iran and that neither the Bidder, nor one (1) of its parents, subsidiaries, and/or affiliates, is involved in any of the investment activities set forth in N.J.S.A. 52:32-56(f). If the Bidder is unable to so certify, the Bidder shall provide a detailed and precise description of such activities as directed on the form. If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

NOTE: In lieu of completing and submitting the paper-based form, the Bidder has the option to complete this certification online in NJSTART on the “Terms and Categories” Tab.

DISCLOSURE OF INVESTIGATIONS AND OTHER ACTIONS INVOLVING BIDDER FORM

The Bidder should submit the Disclosure of Investigations and Other Actions Involving Bidder Form, with its Quote, to provide a detailed description of any investigation, litigation, including administrative complaints or other administrative proceedings, involving any public sector clients during the past five (5) years, including the nature and status of the investigation, and, for any litigation, the caption of the action, a brief description of the action, the date of inception, current status, and, if applicable, disposition. If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

NOTE: In lieu of completing and submitting the paper-based form, the Bidder has the option to complete this certification online in NJSTART on the “Terms and Categories” Tab.

MACBRIDE PRINCIPLES FORM

The Bidder should submit the MacBride Principles Form. Pursuant to N.J.S.A. 52:34-12.2, a Bidder is required to certify that it either has no ongoing business activities in Northern Ireland and does not maintain a physical presence therein or that it will take lawful steps in good faith to conduct any business operations it has in Northern Ireland in accordance with the MacBride principles of nondiscrimination in employment as set forth in N.J.S.A. 52:18A-89.5 and in conformance with the United Kingdom’s Fair Employment (Northern Ireland) Act of 1989, and permit independent monitoring of their compliance with those principles. If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

NOTE: In lieu of completing and submitting the paper-based form, the Bidder has the option to complete this certification online in NJSTART on the “Terms and Categories” Tab.

SERVICE PERFORMANCE WITHIN THE UNITED STATES

The Bidder should submit a completed Source Disclosure Form. Pursuant to N.J.S.A. 52:34-13.2, all Contracts primarily for services shall be performed within the United States. If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

CONFIDENTIALITY/COMMITMENT TO DEFEND

Pursuant to the New Jersey Open Public Records Act (OPRA), N.J.S.A. 47:1A-1 et seq., or the common law right to know, Quotes can be released to the public in accordance with N.J.A.C. 17:12-1.2(b) and (c).

The Bidder should submit a completed and signed Confidentiality/Commitment to Defend Form with the Quote. In the event that the Bidder does not submit the Confidentiality form with the Quote, the State reserves the right to request that the Bidder submit the form after Quote submission.

After the opening of sealed Quotes, all information submitted by a Bidder in response to a Bid Solicitation is considered public information notwithstanding any disclaimers to the contrary submitted by a Bidder. Proprietary, financial, security and confidential information may be exempt from public disclosure by OPRA and/or the common law when the Bidder has a good faith, legal/factual basis for such assertion.

When the Bid Solicitation contains a negotiation component, the Quote will not be subject to public disclosure until a notice of intent to award a Contract is announced.

As part of its Quote, a Bidder may request that portions of the Quote be exempt from public disclosure under OPRA and/or the common law. The Bidder must provide a detailed statement clearly identifying those sections of the Quote that it claims are exempt from production, and the legal and factual basis that supports said exemption(s) as a matter of law. The State will not honor any attempts by a Bidder to designate its State-Supplied Price Sheet, Price List/Catalog, and/or the entire Quote as proprietary and/or confidential, and/or to claim copyright protection for its entire Quote. If the State does not agree with a Bidder’s designation of proprietary and/or confidential information, the State will use commercially reasonable efforts to advise the Bidder. Copyright law does not prohibit access to a record which is otherwise available under OPRA.

The State reserves the right to make the determination as to what to disclose in response to an OPRA request. Any information that the State determines to be exempt from disclosure under OPRA will be redacted.

In the event of any challenge to the Bidder’s assertion of confidentiality that is contrary to the State’s determination of confidentiality, the Bidder shall be solely responsible for defending its designation, but in doing so, all costs and expenses associated therewith shall be the responsibility of the Bidder. The State assumes no such responsibility or liability.

In order not to delay consideration of the Quote or the State’s response to a request for documents, the State requires that Bidder respond to any request regarding confidentiality markings within the timeframe designated in the State’s correspondence regarding confidentiality. If no response is received by the designated date and time, the State will be permitted to release a copy of the Quote with the State making the determination regarding what may be proprietary or confidential.

SUBCONTRACTOR UTILIZATION PLAN

Bidders intending to use Subcontractor(s) shall list all Subcontractors on the Subcontractor Utilization Plan form or may list the Subcontractor(s) on the “Subcontractor” Tab in NJSTART.

For a Quote that does NOT include the use of any Subcontractors, the Bidder is automatically certifying that, if selected for an award, the Bidder will be performing all work required by the Contract.

If it becomes necessary for the Contractor to substitute a Subcontractor, add a Subcontractor, or substitute its own staff for a Subcontractor, the Contractor will identify the proposed new Subcontractor or staff member(s) and the work to be performed. The Contractor shall forward a written request to substitute or add a Subcontractor or to substitute its own staff for a Subcontractor to the State Contract Manager for consideration. The Contractor must provide a completed Subcontractor Utilization Plan, a detailed justification documenting the necessity for the substitution or addition, and resumes of its proposed replacement staff or of the proposed Subcontractor’s management, supervisory, and other key personnel that demonstrate knowledge, ability and experience relevant to that part of the work which the Subcontractor is to undertake. The qualifications and experience of the replacement(s) must equal or exceed those of similar personnel proposed by the Contractor in its Quote. The State Contract Manager will forward the request to the Director for approval.

NOTE: No substituted or additional Subcontractors are authorized to begin work until the Contractor has received written approval from the Director.

3.13.8.1 SMALL BUSINESS SUBCONTRACTING SET-ASIDE CONTRACT

This is a Contract with set-aside subcontracting for New Jersey Small Business Enterprises.

If the Bidder intends to subcontract, it must submit a Subcontractor Utilization Plan and shall take the following actions to make a good faith effort to solicit and hire eligible New Jersey Small Business Enterprises:

A. The Bidder shall attempt to locate qualified potential New Jersey Small Business Enterprises Subcontractors;

B. The Bidder shall request a listing of New Jersey Small Business Enterprises from the Division of Revenue and Enterprise Services, Small Business Registration and M/WBE Certification Services Unit through SAVI (NJSAVI Dataset Story | NJOIT Open Data Center) if none are known to the Bidder;

C. The Bidder shall keep a record of its efforts, including the names of businesses contacted and the means and results of such contacts;

D. The Bidder shall provide all potential Subcontractors with detailed information regarding the specifications; and E. The Bidder shall attempt, wherever possible, to negotiate prices with potential Subcontractors submitting higher than acceptable price quotes.

A Bidder’s failure to satisfy New Jersey Small Business Enterprises set-aside subcontracting or to provide sufficient documentation of its good faith efforts within seven (7) Business Days of a request may preclude award of a Contract to the Bidder.

Each Bidder awarded a Contract which contains the set-aside subcontracting requirement shall fully cooperate in any studies or surveys which may be conducted by the State to determine the extent of the Bidder’s compliance with N.J.A.C. 17:13-1.1 et seq., and this Bid Solicitation.

RESERVED

NOT APPLICABLE TO THIS PROCUREMENT

AFFIRMATIVE ACTION

The intended Contractor and its named Subcontractor(s) must submit a copy of a New Jersey Certificate of Employee Information Report, or a copy of Federal Letter of Approval verifying it is operating under a federally approved or sanctioned Affirmative Action program. If the Contractor and/or its named Subcontractor(s) are not in possession of either a New Jersey Certificate of Employee Information Report or a Federal Letter of Approval, it/they must complete and submit the Affirmative Action Employee Information Report (AA-302). Information, instruction and the application are available at https://www.state.nj.us/treasury/contract_compliance/index.shtml.

RESERVED

NOT APPLICABLE TO THIS PROCUREMENT

STATE OF NEW JERSEY SECURITY DUE DILIGENCE THIRD-PARTY INFORMATION SECURITY QUESTIONNAIRE The Bidder should complete and submit the State of New Jersey Security Due Diligence Third-Party Information Security Questionnaire (Questionnaire) with its Quote. If a Bidder does not submit the completed Questionnaire with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

This Questionnaire is designed to provide the State with an overview of the Bidder’s security and privacy controls to ensure that the Bidder will (1) meet the State of New Jersey’s objectives as outlined and documented in the Statewide Information Security Manual; and (2) comply with the State’s security requirements as outlined in Section 6 – Data Security Requirements – Contractor Responsibility. The State reserves the right to remove a Bidder from consideration of Contract award if the State determines that the Bidder’s Questionnaire failed to sufficiently convey that the Bidder’s security and privacy controls meet the State’s requirements.

The State has executed a Confidentiality/Non-Disclosure Agreement which is attached to the Questionnaire. The Bidder should countersign the Confidentiality/Non-Disclosure Agreement and include it with its submitted Questionnaire. If a Bidder does not submit the signed Confidentiality/Non-Disclosure Agreement with the Questionnaire, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive. No amendments to Confidentiality/Non-Disclosure Agreement are permitted.

To the extent permissible under OPRA, the New Jersey common law right to know, and any other lawful document request or subpoena, the completed Questionnaire and supplemental documentation provided by the Bidder will be kept confidential and not shared with the public or other Bidders.

BUSINESS REGISTRATION

In accordance with N.J.S.A. 52:32-44(b), a Bidder and its named Subcontractors must have a valid Business Registration Certificate (“BRC”) issued by the Department of the Treasury, Division of Revenue and Enterprise Services prior to the award of a Contract. A Bidder should verify its Business Registration Certification Active status on the “Maintain Terms and Categories” Tab within its profile in NJSTART. In the event of an issue with a Bidder’s Business Registration Certification Active status, NJSTART provides a link to take corrective action.

Certification of Non-Involvement in Prohibited Activities in Russia or Belarus The Bidder should submit the Certification of Non-Involvement in Prohibited Activities in Russia or Belarus Form. Pursuant to P.L.2022, c.3, a person or entity seeking to enter into or renew a contract for the provision of goods or services shall certify that it is not Engaging in Prohibited Activities in Russia or Belarus as defined by P.L.2002, c.3, sec. 1(e). If a Bidder does not submit the form with the Quote, the Bidder must comply within seven (7) Business Days of the State’s request or the State may deem the Quote non-responsive.

TECHNICAL QUOTE

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.

NOTE: Bidders are required to submit separate responses for Scope 1 and Scope 2. Combined responses for both scopes will not be considered unless accompanied by stand-alone responses for each scope.

Bids that include the use of Subcontractors identified on a Subcontractor Utilization Plan shall include in the Technical Quote, details on the proposed Subcontractor including the price lines their work will address and should also include a description of the Subcontractor’s business procedures, experience and ability to perform the specified work.

MANAGEMENT OVERVIEW

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.

CONTRACT MANAGEMENT

The Bidder should describe its specific plans to manage, control and supervise the Contract to ensure satisfactory Contract completion according to the required schedule. The plan should include the Bidder’s approach to communicate with the State Contract Manager including, but not limited to, status meetings, status reports, etc.

CONTRACT SCHEDULE

The Bidder shall include a draft Contract schedule. If key dates are a part of this Bid Solicitation, the Bidder’s schedule should incorporate such key dates and should identify the completion date for each task and sub-task required by the Scope of Work. Such schedule should also identify the associated deliverable item(s) to be submitted as evidence of completion of each task and/or subtask.

The Bidder should identify the Contract scheduling and control methodology to be used and should provide the rationale for choosing such methodology.

MOBILIZATION PLAN

SCOPE 1: MEDICAL CLAIMS REVIEWer AND DATA MANAGEMENT It is essential that the State have quick use of the functionality this Contract is to provide. Therefore, each Bidder shall include as part of its Quote a Mobilization Plan, beginning with the date of the fully executed contract award and lasting no longer than six (6) months before the medical Claims reviewer and data analytics functions are implemented and launched.

Such Mobilization Plan should include the following elements:

A. Plans for a Contract award kick-off meeting, to be held in person at DPB or virtually, within ten (10) Business Days of the Contract award. The attendees should include key staff of the Bidder and DPB Contract management staff.

B. A detailed timetable for the Mobilization tasks, which should demonstrate how the Bidder will have the necessary personnel and equipment to begin work on the Contract, operational from the date of Contract Award through to full readiness, and how all Implementation tasks will be managed and completed, as follows:

1. The Bidder’s plan for the deployment and use of management, supervisory or other key personnel during the Mobilization period. The plan should show all management, supervisory and key personnel that will be assigned to manage, supervise and monitor the Bidder’s Mobilization of the Contract within the period of twelve (12) weeks. The Bidder should clearly identify management, supervisory or other key personnel that will be assigned only during the Mobilization;

2. The Bidder’s plan for recruitment of staff required to provide all services required by the Bid Solicitation on the Contract start date at the end of the Mobilization period covering six (6) months. If the Bidder must hire management, supervisory, technical, and/or key personnel upon being awarded the Contract, the Bidder should include, as part of its Mobilization Plan, a plan to secure backup staff in the event personnel initially recruited need assistance or need to be replaced during the Contract term;

C. The Bidder’s plan for the purchase and distribution of equipment, inventory, supplies, materials, and other necessary items.

SCOPE 2: PHARMACY CLAIMS REVIEWER AND TECHNICAL SERVICES

It is essential that the State have quick use of the functionality this Contract is to provide.