Pharmacy Benefit Manager for Worker's Compensation Program

The City of Mesa awarded a two‑year firm‑fixed‑price contract to RxBridge, LLC to serve as the Pharmacy Benefit Manager (PBM) for its workers‑compensation prescription program. The PBM will administer claims, manage formularies, handle both in‑network and out‑of‑network (paper‑billing) prescriptions, provide specialty‑pharmacy services, and deliver extensive monthly and annual reporting, all while interfacing with the City’s RiskMaster CRM system. The contract carries a $150,000 annual value, runs from September 2023 to August 2025, and includes options for up to three additional year renewals and a six‑month extension. Key deliverables include 24/7‑ish customer support, claims processing, utilization reviews, and compliance with Arizona statutes and federal regulations. • Scope: Full PBM services for workers‑comp pharmacy benefits (claims, formulary, reporting, specialty‑drug management). • Performance: Monthly claims and utilization reports, 7 a.m.–6 p.m. service hours, integration with RiskMaster CRM, and adherence to AZ workers‑comp statutes. • Financials: $150,000 per year ($300,000 total for base term) with firm‑fixed pricing and CPI‑based price‑adjustment options.