Pharmacy Benefit Management

The City of Colorado Springs seeks a single vendor to deliver a comprehensive Pharmacy Benefit Management (PBM) program paired with full‑service in‑house pharmacy operations and on‑site disease‑management services. The contractor must manage formulary development, utilization management, network contracting, pricing and rebate transparency, claims adjudication, specialty‑drug handling, member support, and detailed reporting while also operating an on‑site pharmacy that serves city employees, retirees, and workers’‑comp cases, and provides chronic‑disease programs. The contract is a firm‑fixed‑price, five‑year (base two years plus up to three optional years) agreement with strict technology‑security, HIPAA, and accessibility requirements. • PBM services: formulary management, utilization controls, network & pharmacy management, transparent pricing, rebate pass‑through, real‑time claims processing, specialty‑drug programs, reporting/analytics, and compliance support. • In‑house pharmacy: prescription fulfillment for multiple member groups, disease‑management clinics, 24/7 help‑desk support, staffing of pharmacists/technicians, and integration with PBM systems. • Mandatory deliverables: detailed pricing model, financial guarantees, insurance certifications, VPAT, BAA, and a technology rider meeting FedRAMP/StateRAMP standards.