What the buyer needs
AI summaryThe Texas Department of State Health Services seeks proposals for a Pharmacy Benefits Manager. This role will manage prescription drug benefits, premium payments, and copayments for various programs.
Scope of work
- Manage prescription drug benefits for SPAP, TIAP, and TIAP-PLUS
- Pay insurance premiums for qualified health insurance plans
- Pay medication deductibles and copayments as a secondary payor
- Provide call center and health administration services
- Perform claims processing and 3rd party reimbursement
- Provide pharmaceutical and health care management services
How proposals are evaluated
| Criterion | Weight / scoring |
|---|---|
| Qualifications and Experience | 20% |
| Cost Proposal | 35% |
Minimum qualifications
- In business for a minimum of five (5) years or equivalent executive management experience
- Financially solvent and adequately capitalized
- TX-RAMP Level 2 certification prior to award if proposing a SaaS solution
- Set up in the Texas franchise tax system prior to Contract award
- Minimum of three (3) references from similar contracts or projects
Documents to include with your response
- Exhibit A, HHS Solicitation Affirmations, Version 2.10
- Exhibit E, Exceptions Form (if taking exceptions)
- Exhibit H, VetHUB Subcontracting Plan
- Exhibit I, Assurances – Non-Construction Programs
- Exhibit K, Certification Regarding Lobbying
- Exhibit M, Cost Proposal (in Excel format)
- Narrative Proposal (Executive Summary, Project Work Plan, Qualifications and Experience)
- Financial Information (D&B Credit Insights Report, audited financial statements or SEC Form 10K)
- Public Information Act Copy (if claiming confidential information)
- TX-RAMP Documentation (if proposing a SaaS solution)
How to submit
- Method
- USB Drive or Online Bid Room
- Instructions
- Submit two USB drives (Original, Public Information Act Copy if applicable, Cost Proposal in Excel, VetHUB Subcontracting Plan) or upload through the HHS Online Bid Room. Narrative proposal max 40 pages.