PHARMACY BENEFITS MANAGER

The City of Charlottesville is to solicit proposals from qualified vendors to establish a contract through competitive negotiation for the administration of a Pharmacy Benefits Manager (PBM) program for the City of Charlottesville.

• Medical third-party administrator (TPA) services are addressed in a separate solicitation.
• Dental administrative services only (ASO) services are addressed in a separate solicitation.

The City of Charlottesville (“City”) currently offers a comprehensive benefits package to benefits-eligible employees. One of the City’s healthcare plan options includes a Health Reimbursement Account (HRA).

• The City has approximately 1,100 active, benefits-eligible employees with 1,045 enrolled.

• Retiree eligibility: Approximately 90 pre-65 retirees who are not eligible for Medicare may enroll in the medical plan.
• The City currently offers two medical plan options for employees: a point of services (POS) plan and a health maintenance organization (HMO) plan coupled with a (health reimbursement arrangement) HRA. Aetna is the incumbent medical carrier. The HRA is administered by Voya. The City is considering adding a high-deductible health plan HDHP to the plan mix; exact plan design has not yet been finalized.
• The City is seeking proposals for pharmacy benefit management services supporting active employees and pre-65 retirees. Offerors should describe how the PBM will coordinate with the selected medical TPA, including accumulator integration, eligibility exchange, claims data, and reporting.
• Other benefit programs are outside the scope of this RFP.
• The City offers one voluntary vision plan with MetLife.
• The City offers dental insurance with Delta Dental.
• The City offers an Employee Assistance Plan with Sentara.
• The City offers Basic and Voluntary Life through Securian.
• The City offers Long-Term Disability with OCHS/Madison.
• The City offers voluntary benefits with Aetna, Met Life, and Aflac.
• The City offers Flexible Spending Accounts with Voya.
• The City offers retirement plan options.