Minimum Premium Medical and Pharmacy Benefits Services Request for Proposals (RFP)

The County of Los Angeles is seeking proposals for a contract to provide minimum premium medical benefits with carve-in pharmacy and bundled vision plans to a selected group of eligible County employees. The contract term is anticipated to be for a period of an initial term of three years, plus a required transition (implementation) period. The contractor will be expected to implement the requirements outlined in the Statement of Work (SOW) and provide services during normal business hours. • The contractor must have at least 15 years of experience in providing medical and pharmacy benefits, including claims administration services, with adequate access through an extensive network of providers. • The contractor must have a minimum of 5 current clients, including at least one public sector client with at least 25,000 covered lives. • The contractor must provide a full-time Project Manager (Account Executive) or designated alternate with at least 5 years of experience in a project manager capacity. • The contractor must demonstrate it has a medical network that includes at least 90% of the top physicians most frequently utilized by the County’s Enrolled Members. • The contractor must demonstrate it has a behavioral health network that includes at least 90% of the top physicians most frequently utilized by the County’s Enrolled Members. • The contractor must demonstrate it has a pharmacy network that includes at least 90% of the top pharmacies and prescribing physicians most frequently utilized by the County’s Enrolled Members.