Specifications include, but are not limited to: The Hawaii Employer-Union Health Benefits Trust Fund (EUTF) is issuing this Request for Proposals (RFP) for pharmacy benefit consultant services for its self-insured prescription drug plans only. This solicitation is for one contract for which pharmacy benefit consultant services are provided for both the active employee and retiree prescription drug plans. 1. Benefits and plan design, including copay structure, formulary and utilization management strategies 2. Plan administration fees and costs 3. Enrollment 4. Claim utilization, including breakout claims paid by bargaining unit (BU), through the monthly receipt of all claims from the PBM 5. Pharmacy provider network 6. Contract terms with the PBM 7. Performance of the PBM, including annual member satisfaction survey results 8. Services and programs provided by the PBM, including drug savings review, utilization management and clinical programs 9. Sufficiency of funding and reserves 10. Plan compliance with applicable federal and state laws, including but not limited to HIPAA, COBRA, FMLA, ACA, USERRA, Medicare, and tax and insurance laws 11. Identification of cost drivers and determination of whether the PBM has programs in place that address these conditions and whether have been successful. 12. Other matters relating to the performance and administration for the purpose of recommending improvements, modifications or revisions to be considered by the Board.
