Administration of Medical and Vision Plans and Pharmacy Benefits Management

Project Description: The purpose of this Request for Proposal (RFP) is to solicit sealed proposals to establish a contract or contracts through competitive negotiation for the provision of the program(s) described below for eligible employees and retirees of Fairfax County Public Schools (FCPS):
i. Administration of Medical and Vision Plans - Administrative Services Only (ASO) for FCPS’ self-insured medical and vision plan(s), including network management, disease management, claims processing and payment, and operational compliance with federal and state mandates. Services are to be provided for FCPS’ benefits-eligible employees, non-Medicare eligible retirees, and their covered dependents.
ii. Pharmacy Benefit Management for prescription drug coverage to be offered on an integrated or carved out basis with the self-insured medical. PBM services are to be provided for eligible employees, retirees and dependents of FCPS’ self- insured health benefits plan, including Medicare-eligible retirees and their covered dependents. The successful Offeror must be able to administer PBM benefits on an ASO basis, as well as administer an Employee Group Waiver Plan (EGWP) benefit for Medicare-eligible retirees/dependents.