This bid is for pharmacy benefit management services for an employee benefits program in Asheville, Buncombe County, North Carolina.
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What the job is
EDT.
Population: Approximately 1,243 employees, 145 retirees, and 1,065 dependents.
Term: Full implementation by July 1, 2027, for a three-year term with two optional one-year renewals.
Services: National and local pharmacy networks, claims processing, utilization review, chronic condition and specialty drug management, member support, secure portals, and clinical and financial reporting.
Integration: Weekly eligibility feeds from Cigna, deductible and out-of-pocket accumulator coordination, and collaboration with Marathon Health.
TAP administration: $0 copay with deductible bypass only for listed TAP drugs; at least quarterly drug list updates and delivery to Marathon; real-time enrollment and disenrollment, automated administration, and testing before and after launch.
Pricing: Itemize all service, implementation, and ongoing fees, including TAP fees; provide discounts, dispensing fees, rebates, credits, and performance guarantees. Include a $60,000 annual management fee passed through to Willis Towers Watson.
XL Eagle