Description
This solicitation seeks a fully‑insured Medicare Part D EGWP Pharmacy Benefit Management (PBM) provider to administer pharmacy benefits for the Public Education Employees’ Health Insurance Plan (PEEHIP) retirees and dependents across the United States. The awardee will deliver comprehensive PBM services—including claims adjudication, formulary management, network pharmacy oversight, member communications, data reporting, and compliance with CMS and state regulations—while meeting stringent performance guarantees and reporting requirements. The contract runs for one year with up to three optional one‑year extensions, and the selected vendor must be capable of supporting a multi‑state retiree population, providing U.S.-based staff, and maintaining robust security and HIPAA compliance.
• Provide end‑to‑end PBM services (claims, formulary, network, member support, reporting) for ~81 000 Medicare‑eligible retirees and dependents.
• Deliver all services from within the United States, maintain required insurance, HIPAA, E‑Verify, and anti‑boycott certifications, and submit detailed monthly and quarterly performance reports.
• Meet a July 13, 2026 bid deadline, with contract award anticipated September 1, 2026 and a go‑live date of January 1, 2027; the base term is one year with three one‑year renewal options.