ADMINISTRATIVE SERVICES ONLY CONTRACT
FOR THE
STATE OF WISCONSIN GROUP INSURANCE BOARD
PHARMACY BENEFITS MANAGER
RFP # ETJ0007
To: Whom It May Concern:
The purpose of this document is to provide interested and qualified parties
with information to enable them to prepare and submit competitive proposals
to administer pharmacy benefits for the State of Wisconsin (State) and Wisconsin
Public Employers (WPE) group health insurance programs as the Pharmacy Benefits
Manager (PBM). The Group Insurance Board (Board) and the Department of Employee
Trust Funds (ETF) intend to use the results of this process to award a contract
that will begin January 1, 2011 and shall extend through December 31, 2013.
The vendor who is awarded the contract will be responsible for Plan Year 2011
PBM program enrollment activities that begin in the fall of 2010. The implementation
start date will be approximately July 1, 2010. The Board retains the option
by mutual agreement of the Board and the vendor to renew the contract for two
(2) additional two (2)-year periods extending the contract through December
31, 2017 For more information about pharmacy benefits under the State and WPE
group health insurance programs, please refer to the health insurance section
on ETF's Internet site at:
http://etf.wi.gov/publications/insurance.htm
Pharmacy benefits for the State and WPE group health insurance programs are self-funded and managed by the PBM for more than 220,000 participating members associated with total drug costs in excess of $300 million. Functions of the PBM include, but are not limited to, negotiating drug prices and rebates with vendors, maintaining the drug formulary, maintaining the pharmacy network, and managing and processing claims for the pharmacy benefit program. The PBM also provides claim and cost reporting services for the State's participation in the Medicare Retiree Drug Subsidy (RDS) program. This involves more than 24,000 Medicare eligible State retirees and more than $10 million in Federal subsidy.
This procurement is authorized under Chapter 40 of the Wisconsin State statutes. All decisions and actions under this Request For Proposal (RFP) are solely under the authority of the Group Insurance Board. Statutes and rules relating to procurement by other state agencies may not be applicable.
The RFP, and all the associated information is posted on ETF's Internet site at http://etfextranet.it.state.wi.us. All modifications will also be posted on this web site. As such, interested vendors are encouraged to check this web site for updates frequently. No other notification regarding modifications will be provided.
The deadline for receipt of proposals for the RFP is March 3, 2010 at 3:00
PM CST. Late submissions may not be considered. Questions may be emailed to
Jeff Bogardus at jeff.bogardus@etf.state.wi.us. RFP number and title should
be referenced in your email.
1/30/13 | Posting of Contract Document Updates with Navitus Health Solutions, LLC |
12/29/10 | Posting of Contract Documents with Navitus Health Solutions, LLC |
12/29/10 | Posting of Abstract |
12/29/10 | Posting of PBM Vendor Evaluvations |
12/29/10 | Vendor Proposals are being prepred for posting |
4/15/10 | Issue Intent to Award to Navitus Health solutions, LLC |
2/18/10 | Posting of Responses to Vendor Questions - Set 2 |
2/16/10 | Posting of Responses to Vendor Questions - Set 1 |
2/12/10 | Posting of Updated Copy of Current PBM Contract |
2/05/10 | AppendixF - Vendor Reference for Medicare Part D Coverage is Required |
2/05/10 | Section C Administrative Capabilities - New Reference to PBM Contract Exhibit 2 |
Navitus Contract Amendment 6 Signed 1/7/2016 |
Navitus Contract Amendment 5 Signed 5/24/2015 |
Navitus Contract Amendment 4 Signed 2/02/2015 |
Navitus Contract Amendment 3 Signed 4/07/2014 |
Navitus Contract Amendment 2 Signed 11/06/2012 |
Navitus Contract Amendment 2 Effective 4/1/2012 |
Navitus Contract Medicare Part D Effective 1/01/2012 |
Navitus Contract 1/01/2010 thru 12/31/2013 |
Navitus Contract Amendment 1 12/08/2010 |
Navitus Contract Business Associate Agreement |
Document | Web Address |
PBM RFP Main Document Includes Sections A., B., C., & E. and Appendices |
PBM_RFP_Main_Post.docx |
PBM RFP Section D.Cost Proposal | PBM_RFP_SecD_Cost Proposal.docx |
CY 2009 Claims File Extract | PBM_RFP_CY2009 Claims File Extract Dictionary.docx PBM_RFP_CY2009 Claims File Extract.zip |
PBM RFP - Exhibit 1 | PBM_RFP_Exhibit 1_Staffing.xlsx |
PBM RFP - Exhibit 2 | PBM_RFP_Exhibit 2_Formulary Review.xlsx |
PBM RFP - Exhibit 3 | PBM_RFP_Exhibit 3_GeoAccess.xlsx |
PBM RFP - Exhibit 4 | PBM_RFP_Exhibit 4_Pharma-Claims.xlsx |
AppendixF_MedPtD_VendorRef.docx | AppendixF_MedPtD_VendorRef.docx |