Provide self-insured and fully insured Medicare Part D EGWP PBM services with respect to such group insurance coverages, plans and programs as listed in this RFP. The following services are the minimum services requested to be performed by the Offeror(s): # Member Services, including quality and functionality of member website and mobile app # Clinical Programs # Claims Adjudication # Data Reporting (standard and ad-hoc reporting) # Member Enrollment and Eligibility Maintenance # Provider Advocacy and Assistance with Claims Issues # Medicare Part D EGWP Administrative Assistance # Medication Therapy Management # Effective Member Communications # Patient and Family/Caretaker Education and Assistance # Ability to Integrate PBM services with other vendors (e.g. Disease Management, Care Management, Medical), if applicable # Patient and Provider Education # Systematic Prospective, Concurrent, and Retrospective Drug Utilization Review # Network Pharmacy Management # Formulary Management and 100% Pass Through of Rebates Sharing with quarterly payments and NDC rebate reporting # Clinical Program Management # Distribution of ID Cards and Pharmacy Directories # Specialty Pharmacy Program # Complete Availability of IT services, including Online/Real Time Availability to PEEHIP and/or its designee(s) # Pricing Administration # Coordination with a third-party vendor administering the MA benefit
