Description
The Washington State Health Care Authority (HCA) is gathering information via a Request for Information (RFI) to assess potential vendors capable of administering a self‑insured pharmacy benefit for the Uniform Medical Plan (UMP), covering roughly 435,000 members across the Public Employees Benefits Board and School Employees Benefits Board programs. The RFI seeks detailed responses on implementation, organizational capacity, member services, data integration, claims processing, clinical management, pricing models, performance guarantees, and compliance with federal and state regulations. Vendors will submit a concise Exhibit A response (≤30 pages) by the October 9 2026 deadline. This effort will inform a future competitive procurement but does not itself constitute a contract award.
• Scope includes commercial pharmacy benefits and Medicare Part D for retirees.
• Required capabilities: full‑stack pharmacy benefit administration, data‑exchange with medical TPAs, network management, clinical formulary oversight, reporting, and regulatory compliance.
• HCA expects fee‑structure information (e.g., per‑member‑per‑month, rebate‑free pricing) and innovative value‑based proposals.
• No budget is disclosed; the contract is anticipated to support a large, statewide member base.