T2679 - Employee Benefits: Pharmacy Benefits Management

The New Jersey Department of the Treasury, Division of Pensions and Benefits is soliciting quotes for pharmacy benefits management services serving approximately 800,000 members under contract number T2679, with quotes due September 25, 2026 at 2:00 p.m. and an optional pre-quote conference on August 13, 2026. No small business, disabled veteran, minority-owned, or woman-owned set-asides apply.

The scope encompasses prescription drug claims processing, reporting, drug trending and analysis, retail pharmacy network administration, 90-day retail pharmacy networks, mail-order pharmacy services, and specialty pharmacy services for active employees, retirees, and dependents participating in the State Health Benefits Program and School Employees' Health Benefits Program (SHBP/SEHBP). All prescription drug plans are self-insured. The contractor must administer multiple plan designs including standalone and built-in prescription drug plans with varying copayment, coinsurance, and out-of-pocket maximum structures, and coordinate Medicare Part D coverage for retirees.

Bidders must satisfy specific experience requirements: minimum five years administering an employer pharmacy benefit program; annual PBM revenue exceeding $500 million; retail pharmacy network coverage in all 50 states; public sector client experience of at least one year; administration of three or more accounts with at least 100,000 covered members each; and administration of an EGWP + WRAP for at least one client with over 14,000 covered Medicare-eligible retirees.

The contract term begins January 1, 2028, with an anticipated six-month mobilization period. Pricing must be submitted through a state-supplied reverse auction tool and held firm through contract issuance; a minimum of two bidding rounds are anticipated. The State reserves the right to conduct a Best and Final Offer round and to separately procure individual requirements if deemed in its interest. Bidders must execute a Confidentiality/Non-Disclosure Agreement and complete a comprehensive Third-Party Information Security Questionnaire addressing 30 control areas including NIST Cybersecurity Framework, ISO 27001, and CIS alignment prior to accessing confidential census files, utilization data, and claims experience. Questions are due August 21, 2026 at 2:00 p.m. All quotes must be submitted exclusively through NJSTART; email, fax, and hand delivery are not permitted.