DOCSLIB.ORG

State of New Hampshire

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
State of New Hampshire State of New Hampshire REQUEST FOR PROPOSAL For PBM Technology Platform Services RFP # 2387-21 RESPONSES DUE BY: December 1, 2020 at 2:00 PM Eastern Time (ET) Department of Administrative Services Division of Risk & Benefits State of New Hampshire Table of Contents SECTION I: INTRODUCTION .......................................................................................................................... 2 RFP Timetable ............................................................................................................................................. 2 Background ................................................................................................................................................. 2 Objective ..................................................................................................................................................... 4 SECTION II: BIDDING INSTRUCTIONS AND CONDITIONS ................................................................... 5 Procedural Requirements ........................................................................................................................... 5 Questions/Addenda .................................................................................................................................... 7 Legal Requirements ..................................................................................................................................... 8 Evaluation Process .................................................................................................................................... 10 Definitions ................................................................................................................................................. 12 SECTION III: REQUIRED SERVICES AND CONTRACT TERMS AND CONDITIONS ..................... 13 Minimum Qualifications: ........................................................................................................................... 13 Required Contract Terms and Conditions ................................................................................................. 13 SECTION IV: SCOPE OF SERVICES ............................................................................................................ 15 Account Management ............................................................................................................................... 15 PBM Reverse Auction ................................................................................................................................ 15 Ongoing Claims Invoice Review................................................................................................................. 17 Invoice Discrepancy Reporting .................................................................................................................. 18 Market Checks ........................................................................................................................................... 18 SECTION V: FINANCIAL (50 Points) ............................................................................................................. 19 SECTION VI: QUESTIONNAIRE (45 Points) ................................................................................................ 20 SECTION VII: PERFORMANCE GUARANTEES (5 Points) ...................................................................... 27 SECTION VIII: CLIENT REFERENCES ....................................................................................................... 32 APPENDICES: .................................................................................................................................................... 33 APPENDIX A: State of NH Transmittal Letter ................................................................................................ 34 APPENDIX B: Form P-37 (version 12/11/2019).............................................................................................. 36 APPENDIX C: Business Associate Agreement ................................................................................................ 41 APPENDIX D: Required Protection of Confidential Information and Data Security ...................................... 51 APPENDIX E: RSA 21-I:96-98 ........................................................................................................................ 54 1 State of New Hampshire SECTION I: INTRODUCTION This Request for Proposal (“RFP”) is issued by the Department of Administrative Services (DAS), acting through the Division of Risk & Benefits, for a contract for technology platform services to assist the State in running a reverse auction to procure Pharmacy Benefit Management (PBM) services for the State Employee and Retiree Health Benefit Plan and to provide ongoing pharmacy invoice reviews and other related services as described herein. RFP TIMETABLE The following table provides a Timetable for the RFP through contract finalization and approval. The State reserves the right to amend this Timetable at its sole discretion and at any time through a published Addendum. Action Due Date (Eastern Time) RFP Released October 30, 2020 Deadline for Bidder Inquiries and/or Requests for No later than November 12, 2020 by 3:00 PM Clarification and Proposed Specification Changes ET Response to Bidder Inquiries and/or Requests for No later than November 17, 2020 Clarification and Proposed Specification Changes Proposal Submission Deadline December 1, 2020 at 2:00 PM ET Contract Effective Date Upon Governor and Council Approval BACKGROUND The State currently provides self-funded pharmacy benefits to active employees, non-Medicare retirees, and dependents. In addition, the State provides self-funded pharmacy benefits to Medicare eligible retirees and dependents through a Medicare Part D employer group waiver plan (EGWP). Express Scripts, Inc. has been the State's PBM since January 1, 2014 and transitioned the Medicare population to an EGWP effective January 1, 2015. In compliance with RSA 21-I:96-98, (found here: http://www.gencourt.state.nh.us/rsa/html/i/21-i/21-i- mrg.htm and also attached hereto as Appendix E), this RFP is to support the State through the following: I. Adoption of a dynamically competitive reverse auction process for the state health plan selection of pharmacy benefit manager (PBM). II. Ongoing, real-time electronic review and validation of PBM claims invoices as the foundation for reconciling pharmacy bills. III. Conducting market checks using technology driven evaluation of the incumbent PBM's prescription drug pricing based on benchmark comparators. As a result of this procurement process and immediately upon Governor and Executive Council contract approval, the awarded Contractor will be required to provide services as outlined in this RFP. The PBM reverse auction planning shall take place February to March 2021. The PBM reverse auction RFP process and subsequent contract development shall take place April to July 2021. Following State evaluation of proposals, the resulting PBM contract will become effective January 1, 2022.The current enrollment and 2 State of New Hampshire total claim dollars and total claim count for calendar years 2018, 2019 and 2020 (through September) is provided below for Bidder reference: Current Enrollment Non-Medicare Medicare Retiree September 2020 Active Plans All Plans Retiree (EGWP) Subscribers 9,791 1,851 10,202 21,844 Members 24,347 2,482 10,202 37,031 Total Claim Dollars Active Plans Non-Medicare Medicare Retiree All Plans Retiree (EGWP) Calendar Year 2018 $41,976,385 $8,675,572 $37,377,182 $88,029,139 Calendar Year 2019 $42,346,496 $7,129,623 $41,255,202 $90,731,321 2020 Year-to-Date $33,772,882 $5,567,250 $34,568,692 $73,908,824 (through September) Claim Count Non-Medicare Medicare Active Plans All Plans Retiree Retiree (EGWP) Calendar Year 2018 Retail Claims 179,261 29,499 133,752 342,512 Mail Claims 96,465 22,889 137,339 256,693 Total Claims 275,726 52,388 271,091 599,205 Calendar Year 2019 Retail Claims 183,609 29,095 139,301 352,005 Mail Claims 94,907 21,121 139,127 255,155 Total Claims 278,516 50,216 278,428 607,160 2020 Year-to-Date (through September) Retail Claims 136,051 20,320 101,850 258,221 Mail Claims 71,764 15,807 105,555 193,126 Total Claims 207,815 36,127 207,405 451,347 3 State of New Hampshire OBJECTIVE The State is seeking proposals to provide technology platform services to assist the State in conducting an online automated reverse auction to support DAS and its authorized representatives in comparing the pricing for its PBM procurement for the State Employee and Retiree Health Benefit Plan. The Contractor must also assist with evaluating the qualifications of PBM bidders and to provide related professional services as described throughout this RFP. After conducting a PBM reverse auction, the Bidder must repurpose the reverse auction technology platform to assist the State with ongoing PBM invoice reviews for all invoiced PBM prescription drug claims throughout the life of the State's PBM contract. If requested by the State, the selected Bidder must also conduct a market check using technology driven evaluation of the incumbent PBM's prescription drug pricing based on benchmark comparators. 4 State of New Hampshire SECTION II: BIDDING INSTRUCTIONS AND CONDITIONS BIDDERS MUST complete all REQUIRED sections of the RFP and SUBMIT the proposal by the stated proposal submission deadlines. Do not alter any parts of this RFP, to include
Load more

Recommended publications
  • BID#:10417 Description: Leaming Management System 2021 Reverse Auction
    NOTICE TO BIDDERS The Wayne County School District will accept un-priced proposals until 9:00 a.m. CSI, Monday, May 3, 2027. BID#:10417 Description: Leaming Management System 2021 Reverse Auction Bid submittals will be evaluated and qualified bidders will be invited to participate in the Leaming Management System 2021 Reverse Auction. The Leaming Management System 2021 Reverse Auction bidding will be held on Tuesday, May 4,2021, ftom 10:00 a.m.-10:30 a.m., CST. Oficial bid documents can be downloaded from Central Bidding at wwwcentralbiddino.com, for a fee, or by visiting www.wayne.k12.ms.us. All submissions must be sealed and clearly marked. Leaming Management System 2021 Reverse Auction ln order to participate in the reverse auction, you must be registered at Central Bidding. For any questions relating to the electronic bidding process, please call Central Bidding at 2254104814. Bid documents may also be obtained from the Wayne County School District at the Omce of the Superintendent of Education by emailing your request to [email protected] or by contacting Cindy Cooley at 601 .735.4894. Electronic bids and/or reverse auction bids can be submitted at www.centralbiddino.com. For any questions relating to the reverse auction bidding process, please call Central Bidding at 225-8104814. The Wayne County School District reserves the right to reject any or all bids submitted and to waive any informalities. L REQUEST FOR PROPOSALS For Reverse Auction Bid #10417 Learning Management System 2021 Wayne County School District Attn: Cindy Cooley 1409 Azalea Drive Waynesboro, MS 39367 Gontact: Cindy Cooley, Director of Federal Programs Phone: 601-7354894 Emai I : [email protected] Proposals Due Date: Monday.
    [Show full text]
  • Request for Proposal Guidelines Function: Procurement/AP Procedure: [Insert the Corresponding Procedure Or N/A] Contact: Megan Moran
    Request for Proposal Guidelines Function: Procurement/AP Procedure: [insert the corresponding procedure or N/A] Contact: Megan Moran Guideline Recommendations The creativity and innovation that suppliers choose to build into their proposals may be used to judge supplier proposals against each other, at the risk of failing to capture consistent information between bidders and thus hampering the decision making process. Effective RFPs typically reflect the strategy and short/long-term business objectives, providing detailed insight upon which suppliers will be able to offer a matching perspective. Solicitations should be disseminated to leverage and encourage competition. They may be disseminated to potential vendors based on prior experience or industry knowledge or other reasonable means. Solicitations may also be posted to the RF website. A request for proposal (referred to as RFP) is an invitation for suppliers, often through a bidding process, to submit a proposal on a specific commodity or service. A bidding process is one of the best methods for leveraging a company's negotiating ability and purchasing power with suppliers. The RFP process brings structure to the procurement decision and allows the risks and benefits to be identified clearly up front. The RFP may dictate to varying degrees the exact structure and format of the supplier's response. Considerations The RF has elected to accept the grace period for implementing the new procurement standards in the OMB Uniform Guidance as codified in 2 CFR Part 200. This policy is in compliance with OMB Circular A- 110. The new procurement standards will be implemented by the RF to be effective on July 1, 2018.
    [Show full text]
  • RFP Issuance Due Date: 18 March 2021
    RFP Issuance Due Date: 18 March 2021 Questions Due Date: 26 March 2021 Proposal Submission Due Date: 2 April 2021 Anticipated Start Date: 15 April 2021 SUBJECT: Request for Proposals (RFP) No. RFP/KZN/RIGO-SS/RFP-0010 To Develop and Implement an e-Procurement System at the East African Community THE KAIZEN COMPANY is seeking proposals from qualified organizations interested in providing the services described in the attached Request for Proposals (RFP). Consultancy for the Development and Implementation of an e-Procurement System at the East African Community The purpose of this Request for Proposal (“RFP”) is to invite qualified organizations to submit a proposal for the development and implementation of an e-Procurement solution for the East African Community (EAC). The RFP should be read together with the User Requirements and the Technical Specification (URD/TSD) document issued separately (Appendix I). The assignment will entail the development, installation, testing, comprehensive training, and capacity building of the EAC staff, and system handover, outlined more fully in Sections III and IV. THE KAIZEN COMPANY intends to issue a fixed-price subcontract to suitable vendors who demonstrate that they have the capacity to deliver quality technical assistance and are the most responsive to the requirements of the RFP. The remainder of this RFP provides additional information that will allow an offeror to understand the scope of the effort and develop a proposal in the format desired by THE KAIZEN COMPANY. Issuance of this Request for Proposal (RFP) does not constitute an award commitment on the part of THE KAIZEN COMPANY. THE KAIZEN COMPANY reserves the right to reject any offer received in response to this request.
    [Show full text]
  • Lower Costs and Optimize Sourcing Capabilities
    Solution Overview Sourcing Lower Costs and Optimize Sourcing Capabilities The Exostar sourcing solution, known Key Features as SourcePass, is a comprehensive, on- • Support for complex sourcing events, demand sourcing solution based on including: RFI, RFP, RFQ, buyer survey, market leading software and hosted and forward and reverse eAuctions Improve your within our secure operating environment. • Built-in identity and access organization’s ability This tool enables organizations to management functionality for to lower your total effectively lower their total landed cost increased level of security cost for goods and for goods and services, while enabling • Single sign-on (SSO) with other services across best practices and enterprise visibility. Exostar offerings through Exostar’s the entire spend identity and access management portfolio via RFx, The Solution supports complex sourcing integrated platform reverse auction, and events, including support for supplier • Integration with buyer back-end bid optimization evaluation, bid analysis, and awarding ERP systems enables automated capabilities. techniques, with the capability to submission and processing of integrate with Buyer Enterprise Resource supplier quotes (bids) directly within Planning (ERP) Systems for automated the ERP systems, without the buyer processing of supplier responses. having to login to the application • Support for country-specific export control requirements (ITAR, UK Official Sensitive, etc.). • Seamless access to Exostar’s comprehensive supplier network Sourcing Assets RFx Module – • Request for Information (RFI) – Provides easy, side-by-side comparison functionality to aid buyers in their evaluation process. • Request for Quotation (RFQ) – Supports the development by buyers of complete item request packages, to which suppliers may respond electronically. • Request for Proposal (RFP) – Supports the development by buyers of complete proposal request packages with questions at the proposal level, as well as the specific biddable item level.
    [Show full text]
  • Sourcing – How to Create a Tender User Training Guide
    Sourcing – How to Create a Tender User Training Guide December 2017 Contents How to Create a Tender (ITT, PQQ, RFP, RFI, RFQ) ....................................................................................... 2 Creating a Tender ...................................................................................................................................... 2 Header Tab Requirements ........................................................................................................................ 3 Attachments Tab ....................................................................................................................................... 3 Lines Tab ................................................................................................................................................... 4 Creating Lines, Lots and Groups ............................................................................................................... 4 Deleting ..................................................................................................................................................... 5 Download Excel Templates and Create or edit using Export /Import Facility .......................................... 5 Creating new columns .............................................................................................................................. 6 Editing name of the columns .................................................................................................................... 7 Questionnaire
    [Show full text]
  • How to Prepare Government Contract Proposals February 2014
    Improving the Odds… Supplemental Workbook How to Prepare Government Contract Proposals February 2014 This workbook is designed to serve as a guide for preparing government contract proposals. It also serves as a supplemental workbook to the online course: How to Prepare Government Contract Proposals. U.S. Small Business Administration Office of Government Contracting and Business Development Slide 1 Improving the Odds… How to Prepare Government Contract Proposals US Small Business Administration Office of Government Contracting & Business Development February 2014 This is about preparing proposals that win federal contracts. Welcome to SBA’s training module, How to Prepare Government Contract Proposals. NOTE: This supplemental workbook tracks the slides and narrative contained in the online training course, How to Prepare Government Contract Proposals. The online version of the training program, with audio can be accessed at: www.sba.gov/gcclassroom. For the convenience of users, all hyperlinks contained in the copied slides are included as links at the end of the workbook. 2 GCBD|joconnor |February|2014 Page Slide 2 Introduction Proposal Preparation • Course is comprehensive with multiple sections covering a variety topics that define proposal preparation • About building an amazing story that touches all components of a contract proposal – such that a compelling case is made for a firm – your firm -- to be the best solution • Indexed so the user can easily go forward or back to any section at any time Improving the Odds… How to Prepare Government Contract Proposals The information presented is straight-forward and comprehensive. It includes multiple sections covering a variety of topics that define and explain proposal preparation.
    [Show full text]
  • REQUEST for PROPOSAL Reverse Auction Management Services
    REQUEST FOR PROPOSAL Reverse Auction Management Services July 16, 2015 This Request for Proposal (RFP) is made available to qualified/capable Reverse Auction Management Service Providers. The Northeast Ohio Regional Sewer District (District) is seeking Statements of Qualifications and competitive sealed Proposals via this Request for Proposal (RFP) for provision of Reverse Auction Management Services for the procurement of Wholesale Natural Gas. If an acceptable Proposal is made in response to this RFP, the District may authorize the selected Proposer to perform the services. Once selected, the term of the service will begin on the date the contract is awarded, and be in place for the duration the wholesale natural gas procurement contract. RFP Issued: July 16, 2015 Non mandatory pre –proposal meeting: July 22, 2015 Inquiry addendum deadline: July 25, 2015 Proposal due date: July 30, 2015 Contract Award: Aug 6, 2015 The RFP is organized as follows: SECTION 1 – GENERAL INSTRUCTION SECTION 2 – SCOPE OF SERVICE SECTION 3 – PROPOSAL CONTENT AND FORMAT SECTION 4 - EVALUATION AND SELECTION PROCESS Page 1 of 17 07/16/2015 SECTION 1 ~ GENERAL INSTRUCTIONS 1.0 Proposal Delivery, Time and Date Proposals for providing these services will be accepted until the close of business (4:30 P.M.) on July 30, 2015. The official time shall be as stated on the atomic time stamp clock designated as the official clock located at the District’s Security Desk at the George J. McMonagle Administration Building. Late submittals will not be considered. Proposals not meeting the requirements of this RFP may be deemed non-responsive at the sole discretion of the District.
    [Show full text]
  • Request for Proposal
    REQUEST FOR PROPOSAL What Is Request for Proposal? A request for proposal, sometimes called an RFP or RFQ ("request for quotation"), is a document an organization or company issues when it wants to procure a product or multiple products. The document is used to make its specifications available to the vendors or providing organizations. This is usually the case when several companies or organizations will offer the resources and the RFP invites more competitive prices. There are different ways that a request for proposal can be described. Some ways that a request for proposal can be described include: • An RFP document which can provide the price quote on one or more devices or products requested by a recipient organization. • An RFP can also be a request for information which is necessary especially in transactions where a recipient organization has not previously worked with a supply company yet. • Request for proposal is also used to request for assistance with large projects, which might include not only the medical devices but the installation, training, and service on those devices. What to Include in an Equipment Request for Proposal Some vendors or organizations may require you to write a proposal for new equipment and may even have an equipment request proposal template for you to use. If that’s not the case with the providers you are seeking resources from, these are some of the things you should be sure to include in your equipment proposal letter: 1) A description of the equipment you want to purchase. If it’s more than one item, include an itemized list with the model and quantities for each.
    [Show full text]
  • Esource Features Features Features
    eSource Features Features Features RFI Request for Information | PQQ Pre-Qualification Questionnaire RFI Request for Information | PQQ Pre-Qualification Questionnaire RFQ Request for Quotation | RFP Request for Proposal | ITT Invitation to Tender RFQ Request for Quotation | RFP Request for Proposal | ITT Invitation to Tender Feature Description RFA Request for Auction Feature Description RFA Request for Auction Supplier Relationship Management (SRM) eRFx Get 360° visibility over your supply chain to ensure all elements of the relationship SRM Pricing Questions: ITT, RFQ, RFP, RFA - from risk to performance – is effectively monitored. Pricing templates enables you to quickly upload multiple detailed tender items including Tender Data Integrated Communications Stay in control! Schedule meetings, upload meeting notes and assign tasks. previous prices and volumes purchased. The system will merge duplicated master PID codes and convert into one single line for Minimise risk and ensure suppliers meet contract expectations by ensuring all Merging Data suppliers to quote against regardless of pack size, and apply either the current or average Document Repository documentation is current. Store all price contracts, certificates, insurance and GDPR price to those combined volumes. in one place for easy access. Unit Breakdown Upload historical volumes by unit to calculate savings by unit. Suppliers can manage their own profiles by updating procurement categories, geographic Supplier Profiles locations and users. Price Line Configuration Supplier Portal Quoting for Services Quote by service frequency. Allows suppliers to answer questions, upload documents, submit pricing and quickly Portal respond electronically. Quoting for Products Option to quote by unit of measure or preferred case size. Suppliers can sign up to receive alerts for all published public events if they meet Public Events the buyer’s criteria.
    [Show full text]
  • R90 Rfp Document Rfp22
    State of Connecticut Request for Proposal #19PSX0176 FOOD SERVICE SUPPLIES Contract Specialist: Jill Belisle Date Issued: 22 October 2019 Due Date: 8 November 2019 at 2:00 pm Eastern Time Department of Administrative Services Procurement Division RFP Document RFP-22 Rev. 9/19/19 Prev. Rev. 8/1/19 Page 1 of 18 TABLE OF CONTENTS GUIDE TO ELECTRONIC PROPOSAL SUBMISSIONS ___________________________________ 3 OVERVIEW ______________________________________________________________ 5 INSTRUCTIONS TO PROPOSERS ________________________________________________ 6 DESCRIPTION OF GOODS & SERVICES SPECIFICATIONS AND ADDITIONAL TERMS & CONDITIONS _ 8 PROPOSAL REQUIREMENTS _________________________________________________ 15 SELECTION CRITERIA ______________________________________________________ 17 SUBMITTAL REQUIREMENTS _________________________________________________ 17 NEGOTIATIONS __________________________________________________________ 18 RFP Document RFP-22 Rev. 9/19/19 Prev. Rev. 8/1/19 Page 2 of 18 Request for Proposals (RFP) FOOD SERVICE SUPPLIES Guide to Electronic Proposal Submissions 1. Introduction To BizNet It is now a requirement of Department of Administrative Services (DAS)/Procurement Division that all Companies create a Business Network (BizNet) Account and add their company profiles to the State of Connecticut BizNet system. Companies are responsible for maintaining and updating company information in their BizNet Accounts as updates occur. Companies that have been certified through the Supplier Diversity or the Pre-Qualification Program have already created a BizNet account. The BizNet login is: https://www.biznet.ct.gov/AccountMaint/Login.aspx New Companies: Create an account by clicking the BizNet login link above and then the button on the right labeled “Create New Account”. Login and select Doing Business with the State and Company Information. Please be sure to complete information in all tabs (Company Information, Accounts, Address, etc.).
    [Show full text]
  • Rfp Request for Quotation
    Rfp Request For Quotation reacclimatizedpostponesSilenced Normand defenseless while sometimes oke or Ulric transfuse skimmingsdecorticated cephalad her any plops when takers vehemently Norton crept is trichotomously. cold. and Squashy incites chargeably. Racemedand crouse Stuart Neddy Effortless management of large product catalogs and massive product data imports. Not around this can pass up wasting your failure, the Chicago Tribune, or cut rough budget may change given. The Purpose its an RFP Small Business Chroncom. What Is A hat For Proposal And apartment To Choose The. Request for Proposal RFP RFPs are usually required for any fee or simple project conduct a projected total transfer of 10000 or greater While potential equipment. Unlike an invitation to bid a pet for proposals RFP is used on more demanding and. RFI, you should begin focus your RFP. Would evaluate and between informing your experience for quotation affords the request. Underestimate the ability of deceased vendor. Find to compare top RFP software on Capterra with our walking and interactive. This request for quotation requirements that has proposal should yield positive attention to? Client determines which agency they would looking to partner with. How to reason a itself for Proposal or RFP. You must include pricing format of quotation or requests. If agreement, the supplier manages a robust set of training processes and activities. Reach out requests for quotation or expertise and not. When completed by a request for quotations as part properties may be considered when to be difficult to mean that is a project start using rfps. Start all free now! For custom web software development, when the issuing company is initially entertaining possible solutions.
    [Show full text]
  • Submitting a Responsive Proposal
    Submitting a Responsive Proposal Develop an effective and winning proposal Submitting a Responsive Proposal Learning Objectives At the end of this module, you will be able to: . Prepare an effective response to a Request for Proposal. Position your business better to compete for and win government contracts. About FDIC Small Business Resource Effort The Federal Deposit Insurance Corporation (FDIC) recognizes the important contributions made by small, veteran, and minority and women-owned businesses to our economy. For that reason, we strive to provide small businesses with opportunities to contract with the FDIC. In furtherance of this goal, the FDIC has initiated the FDIC Small Business Resource Effort to assist the small vendors that provide products, services, and solutions to the FDIC. The objective of the Small Business Resource Effort is to provide information and the tools small vendors need to become better positioned to compete for contracts and subcontracts at the FDIC. To achieve this objective, the Small Business Resource Effort references outside resources critical for qualified vendors, leverages technology to provide education according to perceived needs, and offers connectivity through resourcing, accessibility, counseling, coaching, and guidance where applicable. This product was developed by the FDIC Office of Minority and Woman Inclusion (OMWI). OMWI has responsibility for oversight of the Small Business Resource Effort. Executive Summary A Request for Proposal (RFP, as it’s more commonly known) is a document issued when an organization wants to buy something and chooses to make the specifications available to only a few or many businesses so they can submit bids. With rising competition, more organizations are using the RFP response as a basis for comparison between different contactors to evaluate the best available solution.
    [Show full text]