City of Canton Quote

Title: PRESCRIPTON PLAN ADMINISTRATION FOR CITY OF CANTON’S HEALTH CARE PLAN

Deadline: 8/19/2022 2:00 PM   (UTC-05:00) Eastern Time (US & Canada)

Status: Awarded

Quote Number: 2022-68

Description: Please see the attached Request for Proposals for the new Prescription Benefit Manager Contract for PRESCRIPTON PLAN ADMINISTRATION FOR CITY OF CANTON’S HEALTH CARE PLAN.


Documents:

Documents as of 7/1/2022
Prescription Benefit Manager Contract - RFP.pdf
Exhibit A - Rx Utilization - City of Canton .xlsx
Exhibit B - 2022-2023 Summary of Benefits - AC & UMR.pdf
Addition 1

Posted: 7/19/2022

Type of Addition: Addendum 1

Overview: Addendum 1
Questions and answers.
Medical and Dental Census Data
UMR Census Data
Dental and Vision Plan Document

Deadline: 8/19/2022 2:00 PM

Documents:

Addition 2

Posted: 7/29/2022

Type of Addition: Addendum 2

Overview: Addendum 2

Questions and answers
Aultcare and UMR Plan Documents

Deadline: 8/19/2022 2:00 PM

Documents:

Addition 3

Posted: 8/3/2022

Type of Addition: Addendum 3

Overview: Addendum 3
Answers to questions
Dental and Vision experience for 2021 and 2022

Deadline: 8/19/2022 2:00 PM

Documents:

Addition 4

Posted: 8/4/2022

Type of Addition: Addendum 3

Overview: Addendum 3
Answers to outstanding questions.

Deadline: 8/19/2022 2:00 PM

Documents:

Addition 5

Posted: 9/16/2022

Type of Addition: In Review

Addition 6

Posted: 3/2/2023

Type of Addition: Aultcare Corporation

Overview: Final award is subject to the City's contracting process and the Auditor's certification of funds.

Question 1

Posted: 7/4/2022

Question: Please provide the following information as soon as you are able. • City of Canton contact name & phone number • Broker/consultant name • Number of total lives count (employees & dependents) • Annual script count • Annual spend • Number of participating members in HDHP

Response: Please see Addendum 1

Question 2

Posted: 7/20/2022

Question: Is there an excel fee /spreadsheet template exhibit for Pharmacy that should also be filled out, like the medical fee spreadsheet?

Response: Please see Addenda.

Question 3

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 8 of RFP, Sample copy of the ASO Agreement. Does this mean an executable version of our contract for City of Canton, or just a sample agreement? The article “the” is prompting the question, do they mean the agreement we’re making specifically for City of Canton? Is a PBM ASO Agreement the same as a Medical ASO Agreement? Both the Med/Dental/Vision and PBM RFPs ask for a “sample copy of the ASO agreement.”

Response: Please see Addenda.

Question 4

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 8 of RFP, Terms & Conditions Page. On Section 9 – Proposal Form, there is a paragraph that reads: “Proposer further agrees that the signing of this Proposal Form represents its acceptance of the terms and conditions set forth within said Request for Proposal.” In Section 3 – Instructions (page 8, number 5), it reads: “Each respondent MUST complete the Proposal Form/Signature page in Section 9 of This RFP, as well as the Terms & Conditions page.” Does the item on the Proposal Form equal the “Terms & Conditions page”? There is no solo “Terms & Conditions” signing page.

Response: Please see Addenda.

Question 5

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 9 of RFP, SOC report (Number 15). Do we include with our RFP submission or after the business is awarded? The instruction states “The successful proposer…,” which indicates that it would be the firm that received the bid that needs to furnish this report.

Response: Please see Addenda.

Question 6

Posted: 7/29/2022

Question: PBM RFP Formatting question – Page 20 of RFP, Section 6 Required Carrier Responses. The numbering is missing numbers 68 and 69 for the questions. Are there missing questions from the RFP? Does the broker want us to answer the RFP using the numbering provided (…65, 66, 67, 70, 71…)?

Response: Please see Addenda.

Question 7

Posted: 7/29/2022

Question: PBM RFP General question – When answering customer service questions, are we OK to provide contacts for both MHS and ESI for the PBM piece?

Response: Please see Addenda.

Question 8

Posted: 7/29/2022

Question: Exhibit A – Rx Utilization – Can you please confirm if the intention is to provide a Rx disruption and/or repricing analysis? If so, the file does not contain formulary status or tier. There is column S included that indicates “FormularyIndc”. The codes included are 0, 1 & 9. Please confirm what this column represents or if column S reflects the formulary status or tier. If this does not reflect formulary status or tier can you please provide a new file that includes formulary status or tier if we should proceed with a disruption and/or repricing?

Response: Please see Addenda.

Question 9

Posted: 7/29/2022

Question: Section 6 - “52. Vendor agrees to provide administrative support for the City of Canton Medicare Part D drug program, including, but not limited to: eligibility maintenance and reconciliation, quarterly drug cost reporting and submission to CMS, annual drug cost reconciliation, preparing and distributing letters of creditable coverage, and ensuring compliance with all CMS and Retiree Drug Subsidy (RDS) requirements. Vendor will fully disclose to COC and CMS in the Part D subsidy billing package all rebates, including those you retain as a formulary management fee, as required by CMS guidance. Vendor also agrees to allow the City of Canton or its designee to audit the Vendor’s administration of the Medicare Part D drug program, including the reconciliation process without additional charges to the City of Canton.” Please clarify if you are requesting us to administer Part D or if this is referencing about RDS and creditable coverage which is not Part D.

Response: Please see Addenda.

Posted: 7/19/2022

Type of Addition: Addendum 1

Overview: Addendum 1
Questions and answers.
Medical and Dental Census Data
UMR Census Data
Dental and Vision Plan Document

Deadline: 8/19/2022 2:00 PM

Documents:

Posted: 7/29/2022

Type of Addition: Addendum 2

Overview: Addendum 2

Questions and answers
Aultcare and UMR Plan Documents

Deadline: 8/19/2022 2:00 PM

Documents:

Posted: 8/3/2022

Type of Addition: Addendum 3

Overview: Addendum 3
Answers to questions
Dental and Vision experience for 2021 and 2022

Deadline: 8/19/2022 2:00 PM

Documents:

Posted: 8/4/2022

Type of Addition: Addendum 3

Overview: Addendum 3
Answers to outstanding questions.

Deadline: 8/19/2022 2:00 PM

Documents:

Posted: 9/16/2022

Type of Addition: In Review

Posted: 3/2/2023

Type of Addition: Aultcare Corporation

Overview: Final award is subject to the City's contracting process and the Auditor's certification of funds.

Posted: 7/4/2022

Question: Please provide the following information as soon as you are able. • City of Canton contact name & phone number • Broker/consultant name • Number of total lives count (employees & dependents) • Annual script count • Annual spend • Number of participating members in HDHP

Response: Please see Addendum 1

Posted: 7/20/2022

Question: Is there an excel fee /spreadsheet template exhibit for Pharmacy that should also be filled out, like the medical fee spreadsheet?

Response: Please see Addenda.

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 8 of RFP, Sample copy of the ASO Agreement. Does this mean an executable version of our contract for City of Canton, or just a sample agreement? The article “the” is prompting the question, do they mean the agreement we’re making specifically for City of Canton? Is a PBM ASO Agreement the same as a Medical ASO Agreement? Both the Med/Dental/Vision and PBM RFPs ask for a “sample copy of the ASO agreement.”

Response: Please see Addenda.

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 8 of RFP, Terms & Conditions Page. On Section 9 – Proposal Form, there is a paragraph that reads: “Proposer further agrees that the signing of this Proposal Form represents its acceptance of the terms and conditions set forth within said Request for Proposal.” In Section 3 – Instructions (page 8, number 5), it reads: “Each respondent MUST complete the Proposal Form/Signature page in Section 9 of This RFP, as well as the Terms & Conditions page.” Does the item on the Proposal Form equal the “Terms & Conditions page”? There is no solo “Terms & Conditions” signing page.

Response: Please see Addenda.

Posted: 7/29/2022

Question: PBM RFP Attachment question – Page 9 of RFP, SOC report (Number 15). Do we include with our RFP submission or after the business is awarded? The instruction states “The successful proposer…,” which indicates that it would be the firm that received the bid that needs to furnish this report.

Response: Please see Addenda.

Posted: 7/29/2022

Question: PBM RFP Formatting question – Page 20 of RFP, Section 6 Required Carrier Responses. The numbering is missing numbers 68 and 69 for the questions. Are there missing questions from the RFP? Does the broker want us to answer the RFP using the numbering provided (…65, 66, 67, 70, 71…)?

Response: Please see Addenda.

Posted: 7/29/2022

Question: PBM RFP General question – When answering customer service questions, are we OK to provide contacts for both MHS and ESI for the PBM piece?

Response: Please see Addenda.

Posted: 7/29/2022

Question: Exhibit A – Rx Utilization – Can you please confirm if the intention is to provide a Rx disruption and/or repricing analysis? If so, the file does not contain formulary status or tier. There is column S included that indicates “FormularyIndc”. The codes included are 0, 1 & 9. Please confirm what this column represents or if column S reflects the formulary status or tier. If this does not reflect formulary status or tier can you please provide a new file that includes formulary status or tier if we should proceed with a disruption and/or repricing?

Response: Please see Addenda.

Posted: 7/29/2022

Question: Section 6 - “52. Vendor agrees to provide administrative support for the City of Canton Medicare Part D drug program, including, but not limited to: eligibility maintenance and reconciliation, quarterly drug cost reporting and submission to CMS, annual drug cost reconciliation, preparing and distributing letters of creditable coverage, and ensuring compliance with all CMS and Retiree Drug Subsidy (RDS) requirements. Vendor will fully disclose to COC and CMS in the Part D subsidy billing package all rebates, including those you retain as a formulary management fee, as required by CMS guidance. Vendor also agrees to allow the City of Canton or its designee to audit the Vendor’s administration of the Medicare Part D drug program, including the reconciliation process without additional charges to the City of Canton.” Please clarify if you are requesting us to administer Part D or if this is referencing about RDS and creditable coverage which is not Part D.

Response: Please see Addenda.