Medical and Pharmacy Benefits

Scottsdale Unified School District #48 is seeking comprehensive medical and pharmacy benefits services through Request for Proposal (RFP) #26001, targeting a fully bundled and integrated approach for approximately 2,382 active benefits-eligible employees across 29 school locations. The procurement aims to evaluate the current health benefit program's structure, cost competitiveness, service capabilities, and potential for increased employee satisfaction while ensuring regulatory compliance. Required services include medical plan administration, case management, utilization review, preferred provider organization (PPO) network access, pharmacy benefit management, wellness programs, and telemedicine services. The RFP anticipates a multi-year contract covering 7/1/24 - 6/30/26, with potential long-term relationship and rate guarantees. Proposal evaluation will utilize a 1000-point scoring system, with 325 points (32.5%) allocated to pricing, considering factors such as multi-year rate guarantees, cost containment strategies, and overall plan costs. Key dates include a September 18, 2025 RFP release, questions due by October 1, 2025, proposals due October 15, 2025 at 1:00 PM Arizona Time, and anticipated award on January 6, 2026.

Currently, the district uses UMR for medical claims administration, UnitedHealthcare for network access, Teladoc for telemedicine, and MaxorPlus for pharmacy benefits, with existing administrative services fees of $33.91 PEPM for medical claims in 2023-2024, increasing to $35.69 PEPM by 2025-2026. USI Insurance Services, LLC is facilitating the RFP process, and all proposals must be submitted net of commissions. The district offers four current plan options: PPO and High-Deductible Health Plans (HDHP) with varying deductible levels, with the district covering majority of employee-only premiums and contributing $500-$1,000 to employee health savings accounts. No specific set-aside designations or restrictions on respondent types are explicitly mentioned in the documentation. Vendors must complete a Data Security and Confidentiality Agreement within seven days of award and are prohibited from direct contact with school board members or selection committee members during the procurement process. While specific budget ranges are not detailed, the comprehensive nature of the procurement suggests a significant annual investment in medical and pharmacy benefits for the district's employees.