The Department of Administration, Division of Retirement and Benefits, is soliciting proposals from qualified and experienced firms to provide Pharmacy Benefit Manager (PBM) services for the AlaskaCare retiree and employee health plans. The State is seeking a firm that can provide competitive financial terms, exceptional customer service, and operational excellence while bringing thoughtful and realistic strategic solutions to improve overall value for the State and for the plan members. The State of Alaska currently has a broad retail pharmacy network that covers all major retail networks and is seeking a similar broad retail network that covers all major retail networks as well as Alaskan independent pharmacies. The State will require the awardee to replicate all current plan designs, and all offerors must be able to administer the benefits as outlined in the existing plan booklets. Links to existing plan booklets are available in Section 2.04. The contract awardee must be prepared to support international claims submissions, including PA requests. The Division’s goals and objectives include: 1. Providing high-quality, exceptional customer service that will “take the member out of the middle”. 2. Providing fiscally sustainable, valuable benefits. 3. Achieving competitive financial terms. 4. Providing transparency in pricing and fee structures. 5. Ensuring the use of evidence-based guidelines in clinical determinations. 6. Strong support and demonstrated flexibility to support plan changes or initiatives. 7. Providing high accuracy in claims processing. 8. Demonstrated ability to manage drug mix with an emphasis on specialty drug management, formulary management and generic drug utilization (ability to identify, dispense and track utilization of authorized generics). 9. Supporting the State in identifying, analyzing, and implementing innovative quality-oriented claims administration processes and procedures to achieve State objectives, reduce costs, and improve quality of service. 10. Providing effective tools and resources to support members in managing their health. 11. Providing seamless implementation for the State and its members. The successful offeror must be able and fully committed to support the State of Alaska with all aspects of the implementation process. Offeror’s proposal must include a detailed implementation timetable with a key task checklist. Offeror must provide a separate implementation plan for each plan group - Active Employees, Non-EGWP Retirees and EGWP Retirees.
