T2679 - Employee Benefits: Pharmacy Benefits Management

The New Jersey Department of the Treasury, Division of Pensions and Benefits is conducting a competitive bid solicitation (T2679) for Pharmacy Benefits Management services covering the State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP). The procurement seeks a comprehensive Pharmacy Benefits Manager (PBM) to administer prescription drug benefits for approximately 800,000 active employees, retirees, and dependents across various plan types, including commercial, early retiree, and Medicare-eligible groups. The contract will utilize a reverse auction pricing model to evaluate bidders, with a focus on pass-through pricing, clinical programs, and financial guarantees. Key requirements include integrated retail, mail order, and specialty drug management with advanced technological capabilities, covering standalone prescription drug services that encompass network access, clinical capabilities, member services, claims management, and robust reporting. The solicitation establishes critical response dates, including an electronic question period closing November 13, 2025, an optional pre-quote conference on October 29, 2025, and a quote opening date of December 17, 2025. Vendors must submit comprehensive documentation through NJSTART, demonstrating compliance with state regulations and providing detailed information about their pharmacy benefits management approach.

The state encourages participation from small, woman-owned, minority-owned, veteran-owned, and disabled veteran-owned businesses, implementing inclusive procurement practices. The contract will have a base term of four years with potential extensions up to two additional years, offering flexibility for long-term partnership. Vendors must provide 100% pass-through of direct and indirect remuneration and rebates, with specific financial terms including guaranteed pricing for ingredient costs, dispensing fees, and specialty drug pricing. While specific budget ranges are not explicitly stated, the scope suggests a significant contract value given the large participant population of approximately 800,000 individuals. The procurement emphasizes comprehensive documentation requirements, including ownership disclosure, investment activity reports, and compliance certifications covering areas such as anti-discrimination policies, cybersecurity protocols, and geopolitical activity restrictions. Potential vendors must complete an extensive Third-Party Information Security Questionnaire and adhere to strict confidentiality agreements, reflecting the state's rigorous approach to selecting a pharmacy benefits management partner.