26-0408-RFP Pharmacy Benefit Manager Services

Pinellas County Board of County Commissioners is issuing RFP 26-0408 to procure comprehensive Pharmacy Benefit Manager (PBM) Services for approximately 3,200 eligible county employees through a competitive Request for Proposal process. The procurement seeks a qualified PBM firm to provide full-service pharmacy benefit management including claims processing, mail order and specialty pharmacy dispensing, clinical management programs, member services, retail network management, and 340B program administration. Qualified proposers must be licensed as a PBM in all 50 states, manage at least one million Rx lives, have a minimum of eight years of experience as a full-service PBM or health plan carrier, and maintain business relationships with 3-5 government or public sector clients in Florida or neighboring states. The contract will span five years with two optional one-year renewal periods, with services commencing January 1, 2027. Proposal responses must not exceed 75 pages and must include vendor qualifications, three references from similar-sized accounts with five years of comparable experience, completed Excel worksheets for plan design and financial requirements, and a signed Business Associate Agreement. The question submission deadline is March 19, 2026 at 10:00 a.m., and proposals must be submitted electronically through the OpenGov procurement platform by March 31, 2026 at 3:00 p.m. Evaluation criteria include financial competitiveness, rate guarantees, customer service capabilities, compliance with Florida Statutes Section 626.8825(2) regarding prescription drug reform, and vendor qualifications. The County intends to award the contract as soon as possible following evaluation.

The RFP does not specify set-aside designations or restrictions limiting responses to disadvantaged enterprises; however, all proposing firms must complete and submit notarized affidavits addressing compliance with human trafficking laws (Florida Statute Section 787.06(14)), foreign country of concern ownership restrictions, and common carrier attestations regarding unauthorized alien transportation. The incumbent vendor is Express Scripts Inc. (ESI), and proposers must be prepared to integrate with existing pharmacy network infrastructure and member data systems. The RFP requires vendors to submit pricing as a five-year lump sum total for PBM administrative services on a per employee per month (PEPM) basis, with detailed pricing for retail, mail order, retail 90-day, and specialty pharmacy claims across all five contract years. Annual pricing adjustments are permitted after the initial twelve months and throughout the contract term, not to exceed the Consumer Price Index or 3%, whichever is less. All pricing guarantees, including discounts and dispensing fees, must be reconciled and paid within 90 days annually, with rebates reconciled within 180 days, and vendors assume dollar-for-dollar risk on any shortfalls. The County reserves the right to terminate the agreement with 90 days' notice without cause and retains the right to reject any or all proposals.