What the buyer needs
AI summaryThe School Board of Hampton seeks proposals from qualified offerors to establish a contract for administrative services for the pharmacy benefit component of its health plan. The selected contractor will administer the pharmacy portion of the self-funded healthcare program for active employees, COBRA beneficiaries, and covered retirees. Responsibilities include ensuring compliance with Health Insurance Portability and Accountability Act certification requirements, coordinating with On-Site Rx to ingest claims and payments, providing monthly claims projections for budgeting, and assigning a single point of contact to handle inquiries, claims, billing, and membership issues. Only onshore USA organizations are eligible to bid, and the contractor will perform the work offsite. Offerors must submit all questions by November 20, 2026. Sealed proposals must be submitted to the issuing office or electronically via DemandStar by December 1, 2026, at 2:00 PM EST.
Scope of work
- Support HCS with guidance on state and federal mandates effective October 1 or throughout the year
- Fulfill certification requirements under HIPAA including all legislative updates
- Provide a single point of contact for resolving issues, questions, billing, and membership changes
- Provide projected monthly claims projections for budgeting purposes
- Maintain separate accounts or subgroups as required by HCS
- Furnish sufficient copies of a detailed summary of benefits including limitations and exclusions
- Provide, at no charge, a variety of reports and annual year-to-date utilization reports
- Provide a detailed renewal underwriting analysis each January 1 for the upcoming October 1 renewal
How proposals are evaluated
| Criterion | Weight / scoring |
|---|---|
| Cost and Cost Guarantees | 30% |
Minimum qualifications
- Authorized to transact business in the Commonwealth of Virginia as a domestic or foreign business entity under Title 13.1 or Title 50
- Possess all necessary licenses and permits required to conduct business
- Registered with eVA before the contract can be fully executed
Documents to include with your response
- Signature Sheet (Pages 1-2 of RFP)
- Attachment C: Offeror Representations and Acknowledgements
- One (1) flash drive of proposal (if not submitted via DemandStar)
- Certificates of Insurance with endorsements (prior to beginning work or within 10 days of intent to award)
How to submit
- Method
- Sealed hard copy or electronic via DemandStar
- Instructions
- Submit sealed proposals in a labeled envelope to the Issuing Office with 1 flash drive (not required if submitted via DemandStar), or submit electronically via DemandStar (www.demandstar.com).