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{"sheet":"Drop Down Lists","index":0,"n_rows":183,"n_cols":3,"rows_kept":183,"cut":false,"hidden":true,"merged":[]}
["ListYes_No",null,"Select one"]
[null,null,"Yes"]
[null,null,"No"]
[]
["List_GEOMap",null,"Select one"]
[null,null,"Zip Code Dispersion"]
[null,null,"Center of Zip Code"]
[null,null,"Geo-coding (Employee Zip Code address)"]
[]
["ListYesNo",null,"Select one"]
[null,null,"Yes"]
[null,null,"No - See Section A-15: Deviations"]
[]
["ListYesNowithCost",null,"Select one"]
[null,null,"Yes, at no additional cost to the State"]
[null,null,"Yes, at an additional cost to the State described below"]
[null,null,"Not offered"]
[]
["List_Agree",null,"Select one"]
[null,null,"Agree"]
[]
["List_Offered",null,"Select one"]
[null,null,"Offered"]
[null,null,"Not offered"]
[]
["List_Complete",null,"Select one"]
[null,null,"Completed"]
[null,null,"Not completed"]
[]
["List_Attached",null,"Select one"]
[null,null,"Attached"]
[null,null,"Not attached"]
[]
["ListCorpTaxStatus",null,"Select one"]
[null,null,"For profit"]
[null,null,"Not for profit"]
[]
["List_NCQA_Accreditation",null,"Select one"]
[null,null,"Accredited"]
[null,null,"Accredation Not Requested"]
[null,null,"Appealed by Plan"]
[null,null,"Denied"]
[null,null,"Full"]
[null,null,"In Process"]
[null,null,"One year"]
[null,null,"Provisional"]
[]
["List_JCAHO_Accreditation",null,"Select one"]
[null,null,"Accreditation Denied"]
[null,null,"Accreditation not requested"]
[null,null,"Accreditation with Commendation"]
[null,null,"Accreditation with Full standards of Compliance"]
[null,null,"Accreditation with Requirements for Improvement"]
[null,null,"Conditional Accreditation"]
[null,null,"Preliminary Denial of  Accreditation"]
[null,null,"Provisional Accreditation"]
[]
["List_URAC_Accreditation",null,"Select one"]
[null,null,"Accreditation Denied"]
[null,null,"Accreditation in Proceess"]
[null,null,"Accreditation Not Required"]
[null,null,"Accreditation Voluntarily Withdrawn"]
[null,null,"Conditional Accreditation"]
[null,null,"Corrective Action"]
[null,null,"Full Accreditation"]
[null,null,"Provisional Accreditation"]
[]
["List_Designated",null,"Select one"]
[null,null,"Dedicated staff"]
[null,null,"Designated staff"]
[]
["List_L14_Q3",null,"Select one"]
[null,null,"Confirmed"]
[null,null,"Not confirmed"]
[]
["List_L14_Q12",null,"Select one"]
[null,null,"0 - 5%"]
[null,null,"6 - 10%"]
[null,null,"Higher than 10%"]
[]
["List_L14_Q16",null,"Select one"]
[null,null,"Yes, a decrease in the network size"]
[null,null,"Yes, an increase in the network size"]
[null,null,"No material change in the network size"]
[]
["List_L14_Q20",null,"Select one"]
[null,null,"Reviewed or verified"]
[null,null,"Not reviewed or verified"]
[]
["List_L14_Q27",null,"Select one"]
[null,null,"Annually"]
[null,null,"Once every two years"]
[null,null,"Other"]
[]
["List_L14_Q32",null,"Select one"]
[null,null,"Less than 3 years"]
[null,null,"3 - 5 years"]
[null,null,"6 or more years"]
[]
["List_L14_Q37",null,"Select one"]
[null,null,"Global Capitation"]
[null,null,"Per Diem"]
[null,null,"Discounted Fee for Service"]
[null,null,"Other"]
[]
["List_L14_Q44",null,"Select one"]
[null,null,"Less than 5%"]
[null,null,"5 - 10%"]
[null,null,"10 - 15%"]
[null,null,"More than 15%"]
[]
["List_L14_Q47",null,"Select one"]
[null,null,"Less than 2 weeks"]
[null,null,"2 - 4 weeks"]
[null,null,"More than 4 weeks"]
[]
["List_L14_Q58",null,"Select one"]
[null,null,"Pay and pursue"]
[null,null,"Pursue and Pay"]
[]
["List_L14_Q67",null,"Select one"]
[null,null,"Yes, both in-network and out-of-network"]
[null,null,"Yes, out-of-network only"]
[null,null,"No"]
[]
["List_L14_Q73",null,"Select one"]
[null,null,"Monthly"]
[null,null,"Quarterly"]
[null,null,"Annually"]
[null,null,"Other"]
[]
["List_L14_Q74",null,"Select one"]
[null,null,"Less than 1%"]
[null,null,"1 - 2%"]
[null,null,"3 - 5%"]
[null,null,"5 - 10%"]
[null,null,"More than 10%"]
[]
["List_L14_Q86",null,"Select one"]
[null,null,"Less than 5%"]
[null,null,"5 - 10%"]
[null,null,"10 - 15%"]
[null,null,"More than 15%"]
[]
["List_L14_Q108",null,"Select one"]
[null,null,"Less than 5%"]
[null,null,"5 - 10%"]
[null,null,"10 - 15%"]
[null,null,"More than 15%"]
[]
["List_L14_Q115",null,"Select one"]
[null,null,"24 hour delay"]
[null,null,"48 hour delay"]
[null,null,"Greater than 48 hour delay"]
[]
["List_L14_Q77",null,"Select one"]
[null,null,"Automated process"]
[null,null,"Manual process"]
[]
["List_L14_Q126",null,"Select one"]
[null,null,"Automatically tracked only"]
[null,null,"Automatically tracked with reporting capabilities"]
[null,null,"Not tracked or reported by the system"]
[]
["List_Exp_Dev",null,"Select one"]
[null,null,"Explanation"]
[]
["List_RxVolume",null,"Select one"]
[null,null,"Increase"]
[null,null,"Decrease"]
[null,null,"No change"]
[]
["List_Confirm",null,"Select one"]
[null,null,"Confirmed"]
[null,null,"Not confirmed"]
[]
["List_Formulary",null,"Select one"]
[null,null,"Preferred Brand Drug"]
[null,null,"Non-Preferred Brand Drug"]
[null,null,"Preferred Specialty Drug"]
[null,null,"Non-Preferred Specialty Drug"]
[null,null,"Generic Drug"]
[null,null,"Excluded Drug"]

{"sheet":"Intro","index":1,"n_rows":15,"n_cols":1,"rows_kept":15,"cut":false,"hidden":false,"merged":[]}
[" "]
[]
[]
[]
[]
[]
["South Carolina Public Employee Benefit Authority"]
["Insurance Benefits"]
["202 Arbor Lake Drive"]
["Columbia, South Carolina 29223"]
[]
[]
[]
["Pharmacy Benefit Management Services"]
["Offeror's Technical Proposal Response"]

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[]
[]
[]
["Request for Proposal for Pharmacy Benefit Management Services"]
["Tab A-1: Background and Qualifications"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
[]
["Instructions: Please complete each cell with the requested information.  Items in the response column with the words, \"Select one\", contain a drop down list of options.  Please select a response from those options as applicable."]
["I.",null,"GENERAL OFFEROR INFORMATION"]
[null,null,null,"Response"]
[null,"1.","Offeror's Legal Name"]
[null,{"$f":"+LEFT(B12,1)+1&\".\"","v":"2."},"Address"]
[null,"3.","City"]
[null,"4.","State"]
[null,"5.","Zip"]
[null,"6.","Web Address"]
[null,"7.","Operational Date"]
[null,"8.","Corporate Tax Status","Select one"]
[null,"9.","Federal Employer Identification Number"]
[null,"10.","Ownership/Controlling Interest"]
[null,{"$f":"+LEFT(B21,2)+1&\".\"","v":"11."},"Describe the Offeror's experience in providing pharmacy benefit management services to South Carolina based clients."]
[null,{"$f":"+LEFT(B22,2)+1&\".\"","v":"12."},"How long has the Offeror administered pharmacy benefits to South Carolina based clients?"]
[null,{"$f":"+LEFT(B23,2)+1&\".\"","v":"13."},"Confirm that the organization is compliant with all applicable HIPAA administrative simplification rules.","Select one"]
[null,{"$f":"+LEFT(B24,2)+1&\".\"","v":"14."},"Provide a detailed description of any recent (within 5 years) HIPAA breaches."]
[null,{"$f":"+LEFT(B25,2)+1&\".\"","v":"15."},"a.) Will your organization be involved in any acquisitions or mergers within the next 12 months?","Select one"]
[null,null,"If yes, please describe."]
[null,null,"b) Has your organization been involved in any recent acquisitions or mergers?"]
[null,null,"w Within the last year?","Select one"]
[null,null,"w 1-2 years ago?","Select one"]
[null,null,"w 2-5 years ago?","Select one"]
[null,null,"w None in the last five years","Select one"]
[null,null,"If yes, please describe."]
[null,{"$f":"+LEFT(B26,2)+1&\".\"","v":"16."},"Confirm that your organization has Errors and Omissions Insurance and Commercial General Liability Insurance.","Please submit a copy of your certificate(s) of insurance indicating coverage limits and label as \"Tab A-1: Certificates of Insurance\"."]
[null,null,"w E & O","Select one"]
[null,null,"w Commercial General Liability","Select one"]
[null,{"$f":"+LEFT(B34,2)+1&\".\"","v":"17."},"If your organization has Errors and Omissions Insurance and/or Commercial General Liability Insurance, please indicate the number of claims filed for each respective coverage in 2023."]
[null,{"$f":"+LEFT(B37,2)+1&\".\"","v":"18."},"Please provide a copy of your organization's most recent audited annual and quarterly update financial statements, including income statements and balance sheets.","Please label as \"Tab A-1: Financial Statements\"."]
[null,{"$f":"+LEFT(B38,2)+1&\".\"","v":"19."},"Provide a copy of your most recent financial ratings and complete the following table.","Please label as \"Tab A-1: Financial Ratings\"."]
[null,null,"A.M. Best"]
[null,null,"w Current Financial Rating"]
[null,null,"w Date of Rating"]
[null,null,"w Prior Financial Rating"]
[null,null,"w Date of rating"]
[null,null,"Standard & Poor's"]
[null,null,"w Current Financial Rating"]
[null,null,"w Date of Rating"]
[null,null,"w Prior Financial Rating"]
[null,null,"w Date of rating"]
[null,null,"Fitch"]
[null,null,"w Current Financial Rating"]
[null,null,"w Date of Rating"]
[null,null,"w Prior Financial Rating"]
[null,null,"w Date of rating"]
[null,{"$f":"+LEFT(B39,2)+1&\".\"","v":"20."},"a.) Total number of covered enrollees, as of December 31, 2024"]
[null,null,"b.) Percent of enrollees, as of December 31, 2024, who are covered through an employer group."]
[null,{"$f":"+LEFT(B55,2)+1&\".\"","v":"21."},"Total number of employer clients, as of December 31, 2024"]
[null,{"$f":"+LEFT(B57,2)+1&\".\"","v":"22."},"Total home delivery prescription volume, based on days of therapy, for the period October 1, 2023 through September 30, 2024."]
[null,{"$f":"+LEFT(B58,2)+1&\".\"","v":"23."},"Total number of home delivery prescriptions for the period October 1, 2023 through September 30, 2024."]
[null,{"$f":"+LEFT(B59,2)+1&\".\"","v":"24."},"Total retail prescription volume, based on days of therapy, for the period October 1, 2023 through September 30, 2024."]
[null,{"$f":"+LEFT(B60,2)+1&\".\"","v":"25."},"Total number of retail prescriptions for the period October 1, 2023 through September 30, 2024."]
[null,{"$f":"+LEFT(B61,2)+1&\".\"","v":"26."},"Provide the total number of prescriptions filled in South Carolina for the following periods."]
[null,null,"October 1, 2021 through September 30, 2022."]
[null,null,"October 1, 2022 through September 30, 2023."]
[null,null,"October 1, 2023 through September 30, 2024."]
[null,{"$f":"+LEFT(B62,2)+1&\".\"","v":"27."},"Please provide a distribution of employer clients by number of members in the following categories.  (Clients do not need to be identified.)"]
[null,null,"Less than 1,000 members"]
[null,null,"1,000 - 4,999 members"]
[null,null,"5,000 - 9,999 members"]
[null,null,"10,000 - 49,999 members"]
[null,null,"50,000 - 99,999 members"]
[null,null,"100,000 - 499,999 members"]
[null,null,"500,000 or more members"]
[null,{"$f":"+LEFT(B66,2)+1&\".\"","v":"28."},"Provide the total covered lives of the Offerors single largest public sector employer for whom it administers an EGWP with Wrap benefit for."]
[null,{"$f":"+LEFT(B74,2)+1&\".\"","v":"29."},"Provide the following enrollment history metrics as of January 1st of each year."]
[null,null,2022]
[null,null,"Number of covered lives:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D80+D79+D78","v":0}]
[null,null,"Number of employer clients:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D85+D84+D83","v":0}]
[null,null,2023]
[null,null,"Number of covered lives:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D91+D90+D89","v":0}]
[null,null,"Number of employer clients:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D96+D95+D94","v":0}]
[null,null,2024]
[null,null,"Number of covered lives:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D102+D101+D100","v":0}]
[null,null,"Number of employer clients:"]
[null,null,"Retail only"]
[null,null,"Home Delivery only"]
[null,null,"Integrated (Home and Retail)"]
[null,null,"Total",{"$f":"+D107+D106+D105","v":0}]
[null,{"$f":"+LEFT(B75,2)+1&\".\"","v":"30."},"For the 12 months ending December 31, 2023, provide the following for your book of business under your managed retail and mail pharmacy programs.  All cost data should be based on total cost before retiree copays/coinsurance."]
[null,null,"Average Ingredient Cost"]
[null,null,"Single-source"]
[null,null,"Multi-source Brand"]
[null,null,"Generic"]
[null,null,"% Dispensing Rates"]
[null,null,"Single-source"]
[null,null,"Multi-source Brand"]
[null,null,"Generic"]
[null,null,"Prescription Counts"]
[null,null,"Single-source"]
[null,null,"Multi-source Brand"]
[null,null,"Generic"]
[null,{"$f":"+LEFT(B109,2)+1&\".\"","v":"31."},"Provide the total spend volume (plan payments, member co-pays and deductibles) administered by the Offeror in calendar year 2023."]
[null,{"$f":"+LEFT(B122,2)+1&\".\"","v":"32."},"The Offeror shall provide any additional information that indicates that it is capable of administering a program for the Plan the size of PEBA, including any experience and/or innovations in the administration of similar contracts."]
[null,{"$f":"+LEFT(B123,2)+1&\".\"","v":"33."},"a.) Is the Offeror and/or any of its Principals presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any state or federal agency? \"Principals\" means officers; directors; owners, partners; and persons having primary management or supervisory responsibilities within a business entity (e.g. general manager; plant manager; head of a subsidiary, division or business segment; and similar positions).","Select one"]
[null,null,"b.) If yes, please explain."]
[null,{"$f":"+LEFT(B124,2)+1&\".\"","v":"34."},"a.) Has the Offeror and/or any of its Principals, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, state or local) contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property?","Select one"]
[null,null,"b.) If yes, please explain."]
[null,{"$f":"+LEFT(B126,2)+1&\".\"","v":"35."},"a.) Has the Offeror been the subject of an ERISA investigation?","Select one"]
[null,null,"b.) If yes, please explain."]
[null,{"$f":"+LEFT(B128,2)+1&\".\"","v":"36."},"a.) Is the Offeror and/or any of its Principals presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in question #33 above?","Select one"]
[null,null,"b.) If yes, please explain."]
[null,{"$f":"+LEFT(B130,2)+1&\".\"","v":"37."},"a.) Has the Offeror, within a three-year period preceding this offer, had one or more contracts terminated for default by any public (Federal, state or local) entity?","Select one"]
[null,null,"b.) If yes, please explain."]
[null,{"$f":"+LEFT(B132,2)+1&\".\"","v":"38."},"PEBA is seeking a relationship with a PBM that is fiduciary in nature. How would you propose to create such a relationship. Be sure to include limitations on the relationship as well."]
[null,{"$f":"+LEFT(B134,2)+1&\".\"","v":"39."},"Please provide a list of public sector clients of similar size to PEBA for which the Offeror has performed, at any time during the past three years, services substantially similar to those sought with this solicitation.  List commercial clients separately from EGWP clients.","Please label as \"Tab A-1: Public Sector Client List\"."]
[null,{"$f":"+LEFT(B135,2)+1&\".\"","v":"40."},"Please provide a list of failed projects, suspensions, debarments, and significant litigation.","Please label as \"Tab A-1: Failed Projects, Suspensions, Disbarments\"."]
[null,{"$f":"+LEFT(B136,2)+1&\".\"","v":"41."},"Please provide a detailed, narrative statement listing the three most recent, comparable contracts (including contact information) which you have performed.","Please label as \"Tab A-1: Detailed Narrative Statement\"."]
[]
["II.",null,"CONTACT INFORMATION"]
[null,null,"Please identify both the primary contact, who can answer questions related to this RFP, and the account manager, who will have overall responsibility for planning, supervising and performing account services. "]
[]
[null,null,"Primary Contact"]
[null,null,"Name"]
[null,null,"Title"]
[null,null,"Address"]
[null,null,"City"]
[null,null,"State"]
[null,null,"Zip"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"Cell Phone #"]
[null,null,"E-mail Address"]
[]
[null,null,"Account Manager"]
[null,null,"Name"]
[null,null,"Title"]
[null,null,"Address"]
[null,null,"City"]
[null,null,"State"]
[null,null,"Zip"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"Cell Phone #"]
[null,null,"E-mail Address"]
[]
["III.",null,"MANDATORY MINIMUM QUALIFICATIONS"]
[null,null,"In order for an Offeror to be considered for an award it must demonstrate that it possesses, as of the date of the proposal submission, all of the following minimum qualifications: For each item, please provide detailed specifics how the Offeror satisfies the requirement."]
[]
[null,null,"Minimum Qualifications","Response"]
[null,"1.","Offeror must have been in the business of providing Pharmacy Benefit Management Services, including administration of a retail pharmacy network, for a minimum of five (5) years. "]
[null,"2.","Offeror must be currently accredited by the Utilization Review Accreditation Commission (URAC) in pharmacy benefits management."]
[null,"3.","Offeror must be certified by CMS to administer and adjudicate an Indirect Employer Group Waiver Plan."]
[]
["IV.",null,"REFERENCES"]
[null,null,"Please complete the following tables with the requested reference information."]
[]
[null,"1.","Please provide references for two large clients similar to PEBA for whom you provide similar prescription drug benefits administration.  At least one of the references must be a public sector client."]
[null,null,"Information ","Reference #1","Reference #2"]
[null,null,"Company Name"]
[null,null,"Contact Person"]
[null,null,"Title"]
[null,null,"City, State"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"E-mail Address"]
[null,null,"# Covered Lives"]
[]
[null,"2.","Please provide references for two clients with more than 25,000 lives for whom you provide similar prescription drug benefits administration.  At least one of the references must be a public sector client."]
[null,null,"Information ","Reference #1","Reference #2"]
[null,null,"Company Name"]
[null,null,"Contact Person"]
[null,null,"Title"]
[null,null,"City, State"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"E-mail Address"]
[null,null,"# Covered Lives"]
[]
[null,"3.","Please provide references for two former clients with more than 25,000 covered lives for whom you provided similar prescription drug benefits administration. At least one of the references must be a public sector client."]
[null,null,"Information ","Reference #1","Reference #2"]
[null,null,"Company Name"]
[null,null,"Contact Person"]
[null,null,"Title"]
[null,null,"City, State"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"E-mail Address"]
[null,null,"# Covered Lives"]
[]
[null,"4.","Please provide references for two clients who began utilizing your prescription drug benefit administration services within the last twelve months.  At least one of the references must be a public sector client."]
[null,null,"Information ","Reference #1","Reference #2"]
[null,null,"Company Name"]
[null,null,"Contact Person"]
[null,null,"Title"]
[null,null,"City, State"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"E-mail Address"]
[null,null,"# Covered Lives"]
[]
[null,"5.","Please provide references for two clients (public or private sector) similar to PEBA for whom you administer an Indirect EGWP with Wrap program for Medicare participants."]
[null,null,"Information ","Reference #1","Reference #2"]
[null,null,"Company Name"]
[null,null,"Contact Person"]
[null,null,"Title"]
[null,null,"City, State"]
[null,null,"Telephone #"]
[null,null,"Fax Phone #"]
[null,null,"E-mail Address"]
[null,null,"# Covered Lives"]

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[]
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[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2a: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["A.   PRICING AND COST CONTAINMENT"]
["Q-1","The Contractor shall provide and maintain a comprehensive drug utilization review program that is based on the highest quality comparative effectiveness research, as well as lowest net cost objectives, and includes dose and quantity limits, and concurrent, prospective, and retrospective therapeutic drug monitoring with the objectives of: minimizing the risk of adverse drug interactions or drug-induced illness; increasing use of drug therapies that are medically necessary and most clinically and cost effective; minimizing the risk of over utilization of medications; identifying individual prescribers and/or pharmacies that demonstrate patterns of possible misuse; and promoting cost effective drug therapies in accordance with national prescribing guidelines. The drug utilization review program shall include an opioid management program that promotes patient safety by ensuring appropriate prescribing of opioids and is compliant with both federal and state guidelines. The Contractor shall maintain its drug utilization review program to be current with the market and current literature, and to be consistent with PEBA’s strategic goals. The Contractor shall proactively implement new programs and/or strategies as market and trend conditions dictate.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"Please provide a detailed utilization management program list, including specific drug names in each program.","Label as \"Tab A-2a: Detailed Utilization Management Program List\"."]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"Please provide the following information for each prospective/retrospective DUR program you offer and include two references."]
[null,"Program #1"]
[null,"a.) Number of programs implemented to date"]
[null,"b.) PMPM savings associated with the program"]
[null,"c.) Risk sharing Arrangements (if any) including outcomes or cost savings"]
[null,"d.) PMPM Program Costs (if any)"]
[null,"e.) Reference #1 (name/contact/phone)"]
[null,"f.) Reference #2 (name/contact/phone)"]
[null,"Program #2"]
[null,"a.) Number of programs implemented to date"]
[null,"b.) PMPM savings associated with the program"]
[null,"c.) Risk sharing Arrangements (if any) including outcomes or cost savings"]
[null,"d.) PMPM Program Costs (if any)"]
[null,"e.) Reference #1 (name/contact/phone)"]
[null,"f.) Reference #2 (name/contact/phone)"]
[null,"Program #3"]
[null,"a.) Number of programs implemented to date"]
[null,"b.) PMPM savings associated with the program"]
[null,"c.) Risk sharing Arrangements (if any) including outcomes or cost savings"]
[null,"d.) PMPM Program Costs (if any)"]
[null,"e.) Reference #1 (name/contact/phone)"]
[null,"f.) Reference #2 (name/contact/phone)"]
[null,"Program #4"]
[null,"a.) Number of programs implemented to date"]
[null,"b.) PMPM savings associated with the program"]
[null,"c.) Risk sharing Arrangements (if any) including outcomes or cost savings"]
[null,"d.) PMPM Program Costs (if any)"]
[null,"e.) Reference #1 (name/contact/phone)"]
[null,"f.) Reference #2 (name/contact/phone)"]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-4"},"The Contractor shall provide a system of coverage reviews for selected medications, including the use of step therapy algorithms based on national prescribing guidelines that require trials on less expensive yet equally clinically effective alternatives prior to prescribing more expensive drug therapies. The Contractor shall maintain its step therapy programs to be current with the market and current literature, and to be consistent with PEBA’s strategic goals. The Contractor shall proactively recommend for PEBA’s approval for implementation, new programs and/or strategies as market and trend conditions dictate.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A44,1)+1","v":"Q-5"},"Describe, in detail, your system of coverage review for selected medications, including the use of step therapy algorithms based on national prescribing guidelines."]
[{"$f":"+\"Q-\"&RIGHT(A45,1)+1","v":"Q-6"},"Describe your background and experience with the following clinical programs:"]
[null,"a.) concurrent drug utilization review"]
[null,"b.) retrospective drug utilization review"]
[null,"c.) prospective drug utilization review"]
[null,"d.) prior authorization"]
[null,"e.) step therapy"]
[{"$f":"+\"Q-\"&RIGHT(A46,1)+1","v":"Q-7"},"Describe the activities involving outreach to physicians with regard to prescription drug cost containment."]
[{"$f":"+\"Q-\"&RIGHT(A52,1)+1","v":"Q-8"},"a.) How do you demonstrate to Members their personal savings associated with changing medications from their current prescriptions?"]
[null,"b.) Does this function use existing claim history, PEBA specific plan design and pricing as a starting point?"]
[null,"c.) If you have this capability, what have you seen for utilization patterns and changes from brand to generic medications?"]
[{"$f":"+\"Q-\"&RIGHT(A53,1)+1","v":"Q-9"},"Please describe programs you have implemented to expedite conversion to newly released generic medications. Please provide examples."]
[{"$f":"+\"Q-\"&RIGHT(A56,1)+1","v":"Q-10"},"How would you propose to optimize the mix between retail, retail maintenance (retail 90) and home delivery prescriptions?"]
[{"$f":"+\"Q-\"&RIGHT(A57,2)+1","v":"Q-11"},"Please identify how you would propose to monitor and increase member's prescription compliance."]
[{"$f":"+\"Q-\"&RIGHT(A58,2)+1","v":"Q-12"},"a.) Do you have a managed injectable program?  If so, please describe."]
[null,"b.) Are you partnered with anyone for your managed injectable program?"]
[null,"c.) Does your proposed price include the cost of this program?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A59,2)+1","v":"Q-13"},"Briefly describe your organization’s capabilities in monitoring the costs and utilization of compound drugs."]
[{"$f":"+\"Q-\"&RIGHT(A62,2)+1","v":"Q-14"},"With respect to plan design and utilization management options, briefly describe each of your organization’s solutions to controlling the costs and utilization of compound drugs."]
["Q-15","The Contractor shall propose a drug formulary in conjunction with preferred drug list (PDL) that will be made available to Plan Participants. PEBA currently uses the incumbent’s National Preferred Formulary for the Commercial Plan and fully supports exclusion of medications as the result of robust clinical and financial analysis. PEBA shall be an active partner with the Contractor in the maintenance and customization of the PDL proposed by the Contractor (if necessary). PEBA understands that formulary positioning is a critical element for the purposes of capturing pharmaceutical industry revenue. As such, the Contractor shall provide PEBA the entirety of data and information necessary to make fully informed PDL decisions. These data include but are not limited to, all pharmaceutical revenue streams generated, discounts, market share and inflation protection for medications being considered under a PDL change. The Contractor shall implement changes to the formulary, step therapy, prior authorization (PA) and other clinical edit requirements within seventy-five (75) business days of PEBA’s approval or request. Additional time, beyond seventy-five (75) business days might be granted with PEBA’s prior approval in writing. Changes shall include modifications to the point-of-service (POS) system and all supporting systems and documents. The Contractor shall notify pharmacy providers and affected members in writing at least sixty (60) days prior to the implementation unless PEBA requests a shorter notification time. PEBA must provide prior approval in writing for all pharmacy provider and member notifications.","Select one"]
["Q-16","The Contractor shall not implement or administer any program that results in the therapeutic switching of Members from lower net cost products to higher net cost products. The only exceptions are for Member safety or efficacy issues or, upon notification to PEBA and with prescriber approval, in response to widespread marketplace drug availability issues with the more cost-effective product.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A65,2)+1","v":"Q-17"},"Please provide a detailed description of how your organization determines which drugs are preferred versus non-preferred.","Label as \"Tab A-2a: Formulary Development Criteria\"."]
["Q-18","Does your organization use AWP, NADAC, or some other prescription drug cost benchmark in your contracts with retail pharmacies? Explain your choice."]
["Q-19","The Contractor shall provide a Maximum Allowable Cost (MAC) pricing, with the most favorable pricing to PEBA for  generic prescription drugs that uses a MAC price list. A generic prescription drug is defined as a prescription drug that has a Medi-span multisource status of “Y” as of the dispense date. This MAC price list is subject to review and modification for inclusion of generic drugs representing the greatest cost savings to the Plan based on Participants’ drug utilization; however, PEBA will determine such pricing for 30-day supply generic prescription drugs filled at PEBA-defined, locally owned pharmacies in conjunction with the Contractor. PEBA will collaborate with the Contractor to determine locally owned pharmacy pricing for 30-day supply generic prescription drugs in terms of dispensing fees and an effective relativity to non-locally owned retail pharmacies using a mutually agreeable price benchmark system (including but not limited to discount from Average Wholesale Price (AWP), National Average Drug Acquisition Cost (NADAC), etc.), and communicate to the Contractor no less than 30 days prior to the effective date of such pricing . The contractor shall utilize the same MAC pricing lists for all generic prescriptions filled at non locally owned and home delivery pharmacies.","Select one"]
["Q-20","Provide the following data on your MAC program. "]
[null,"a.) A copy of your proposed MAC list in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and price per metric quantity.","Please label as \"Tab A-2a: MAC List - Commercial Plan\"."]
[null,"b.) Number of generic classes on MAC list"]
[null,"c.) Number of multi-source brand drugs for which the MAC list provides substitution alternatives (all dosage forms of multi-source drug counted as one)"]
[null,"d.) Package size basis for maximum MAC price"]
[null,"e.) MAC drugs as a percent of total generic drugs dispensed"]
[null,"f.) Average MAC cost as a percent of total generic drug cost"]
[null,"g.) Average generic cost as a percent of average multi-source brand drug cost"]
[null,"h.) Expected total generic dispensing rate using MAC program"]
[null,"i.) Guarantee on total generic dispensing rate using MAC program"]
[null,"j.) Expected MAC savings as a percent of plan ingredient cost (total brand and generic cost)"]
[null,"k.) Number of MAC drugs added in the past 12 months"]
[{"$f":"+\"Q-\"&RIGHT(A69,2)+1","v":"Q-21"},"The Contractor shall propose net per member per month (PMPM) cost guarantees for both the Commercial and EGWP plans. Proposed pricing guarantees shall be calculated as the sum of administrative expenses plus Plan (net of cost share) claim expenses less any pharmaceutic revenue divided by the number of member months in the Commercial and EGWP plans. The calculation shall be performed separately for the Commercial and EGWP plans. Exclusions to the per member net cost guarantees are as follows:","Select one"]
[null,"a.) Brand and generic 30-day supply prescription drugs filled at South Carolina based, locally-owned pharmacies as defined by PEBA;"]
[null,"b.) Brand drugs that are new to market during the Plan calendar year;"]
[null,"c.) Nursing home based pharmacies;"]
[null,"d.) Veterans Administration and all Military Treatment Facility pharmacy claims; and"]
[null,"e.) Compound prescription drugs."]
[{"$f":"+\"Q-\"&RIGHT(A81,2)+1","v":"Q-22"},"The Contractor shall reconcile the actual net PMPM with the guaranteed PMPM amount on an annual basis. The Contractor shall reimburse PEBA the calculated financial difference between actual net PMPM cost performance and the guaranteed net PMPM cost performance up to the amount put at risk by the offeror. This reconciliation, including payment amounts to PEBA, shall occur one hundred-eighty (180) days after the end of each Plan year and will be based on administrative fees, claims and pharmaceutical rebate monies accrued and paid up to 180 days after the end of each Plan year.","Select one"]
[null,"a.) Contractor shall provide separate plan year 2026 net PMPM guarantees for both the non EGWP and EGWP plans. For the sake of clarity, net PMPMs shall be calculated as plan cost (net of patient cost share) plus all administrative fees paid by PEBA to the contractor less all pharmaceutical industry revenue divided by the number of member months for each plan.  Only claims explicitly listed in A.6 will be excluded from the plan cost component of the calculation. No other claims will be excluded from the calculation.  There are no prescription exclusions for pharmaceutical industry revenue. All pharmaceutical revenue will be paid to PEBA."]
[null,"b.) The net PMPM guarantees for 2027 will be calculated as the net PMPM guarantees for 2026 trended forward by Milliman Health Trend Guidelines less 30% than the reported trend under the completed “South Atlantic ASO completed drug” subset.  Net PMPM guarantees for years subsequent to 2027 will be trended forward using the same methodology."]
[null,"c.) Claims will not be adjusted for demographic and geographic shifts."]
[null,"d.) Large claims/claimants will not be excluded."]
[{"$f":"+\"Q-\"&RIGHT(A87,2)+1","v":"Q-23"},"The Contractor shall provide 100% of all pharmaceutical manufacturer rebate monies attributable to PEBA business for both the Commercial and EGWP plans. The Contractor will remit to PEBA within sixty (60) days of the end of each Plan quarter (March 31, June 30, September 30 and December 31) all pharmaceutical manufacturer rebate monies earned on PEBA utilization and paid to the Contractor or its subcontractor during the previous Plan calendar quarter. Rebates accrued and received by the Contractor or its subcontractor for PEBA utilization not yet paid to PEBA in previous quarterly payments shall be remitted along with the next scheduled quarterly rebate payment. If the Contractor utilizes a subcontractor for rebate aggregation services, such as a Group Purchasing Organization(GPO), the cost for that subcontractor shall be included in the fixed, all-inclusive PMPM administrative fee.  The GPO cannot withhold any pharmaceutical revenue generated by PEBA utilization under any circumstances. In the event the Contractor utilizes a GPO or similar entity for rebate aggregation, additional documentation sufficient to satisfactorily prove to an independent auditor selected by PEBA, that no pharmaceutical revenue has been retained by the GPO must be provided. For the sake of clarity, the Contractor, or any other entity either affiliated or owned by the Contractor, cannot retain any pharmaceutical revenue.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A92,2)+1","v":"Q-24"},"PEBA has the right to audit copies of the Contract and any supporting materials between the pharmaceutical manufacturers, the Contractor and any subcontractor or affiliate it may use for the purposes of pharmaceutical manufacturer rebate monies aggregation. The audit will include only those portions of the pharmaceutical manufacturer agreements as necessary to determine Contractor compliance with the terms and conditions of this Contract between PEBA and the Contractor and shall include an overview of the processes for reporting data to manufacturers, accounting for rebates earned and allocating rebates to PEBA. An audit may be requested once annually and will be conducted between January through September in a mutually agreeable location as scheduled by agreement of the parties but no sooner than sixty (60) days after execution of a confidentiality agreement between PEBA, the Contractor and other necessary parties. PEBA shall have the exclusive right to select as PEBA's auditor any entity PEBA chooses, provided that any audit of the Contractor’s agreements with pharmaceutical manufacturers may be conducted only by entities that:","Select one"]
[null,"a.) Have demonstrable experience in conducting pharmaceutical manufacturer revenue audits;"]
[null,"b.) Carry insurance for professional malpractice of at least $2,000,000; and"]
[null,"c.) Have executed a mutually agreeable confidentiality agreement with the Contractor."]
[null,"Audit of pharmaceutical manufacturer agreements may include no more than 10 pharmaceutical manufacturers and/or 80% of rebate spend."]
[{"$f":"+\"Q-\"&RIGHT(A93,2)+1","v":"Q-25"},"The Contractor shall provide a transparent financial pricing arrangement in which it discloses all sources of revenues derived by relationships with pharmaceutical manufacturers from PEBA's utilization at all home delivery and retail pharmacies, as well as all pharmaceutical manufacturer fees that offset costs associated with required clinical applications and/or services conducted by the Contractor to support the dispensing of certain medications. PEBA must receive all monies from pharmaceutical manufacturers that are attributable to PEBA's utilization. Fees from received pharmaceutical manufacturers that are for the purpose of offsetting costs associated with required clinical applications and/or services, while required to be identified, are not required to be passed to PEBA. The items listed in below shall be included within the fixed, all-inclusive PMPM Commercial Plan administrative fee and within the fixed, all-inclusive PMPM EGWP Plan administrative fee offered in Line 1 and Line 2 respectively of Table I of Tab A-10: Financial Proposal. The Contractor shall include at a minimum the services detailed in Attachment 7 whether directly provided or provided through a subcontractor or affiliate.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A98,2)+1","v":"Q-26"},"The EGWP administrative fee quoted in Line 2 of Table I in Tab A-10: Financial Proposal shall be a composite fee for Medicare primary Members enrolled in the EGWP Plan as determined by the Contractor. The Contractor shall include at a minimum the following services in the fixed, all-inclusive PMPM EGWP Plan administrative fee for Members who enroll in the EGWP Plan.","Select one"]
[null,"a.) Monthly cost report submission to CMS, regardless of frequency of submission selected by PEBA"]
[null,"b.) Paper claim submission fee for coordination of benefits for Medicare Part D enrollees"]
[null,"c.) Prior authorizations to categorize Part B covered drugs for exclusion from claim submission in accordance with CMS guidelines and in coordination with PEBA"]
[null,"d.) Storage of data for CMS audit, and participation in CMS audits, as needed"]
[null,"e.) Certificates of Coverage at termination of Creditable Coverage, including postage and mailing"]
[null,"f.) Calculation and submission annually of the final reconciliation cost report to CMS"]
[{"$f":"+\"Q-\"&RIGHT(A99,2)+1","v":"Q-27"},"Describe, in detail, how you will disclose all revenue sources derived by relationships with pharmaceutical manufacturers, at home delivery and at retail."]
[{"$f":"+\"Q-\"&RIGHT(A106,2)+1","v":"Q-28"},"The Medicare coordination of benefits solution administrative fee quoted in Line 3 of Table I in Table A-10: Financial Proposal shall be a composite fee for Medicare primary Members enrolled in the EGWP Plan and for those Medicare primary Members who opt out of the EGWP Plan and enroll in the Commercial Plan. This Contractor shall include at a minimum its solution to require certain medications and supplies that are covered under Medicare Part B (medical coverage) be paid primary by Medicare and secondary by the State Health Plan medical benefits.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A107,2)+1","v":"Q-29"},"The Contractor shall offer a biosimilar strategy to encourage prescribers and members to utilize FDA-approved biosimilar medications ahead of originator products.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A108,2)+1","v":"Q-30"},"The Contractor must offer a specialty pharmacy program that includes clinical applications specifically for specialty products. As part of the specialty pharmacy program, the Contractor needs to administer the specialty pharmacy network as described in Section B.6.","Select one"]
["Q-31","The Contractor shall administer PEBA’s incentive-based generic prescription drug copay waiver program, No-Pay Copay. In this program, non-Medicare primary subscribers and spouses designated by the third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, shall receive generic prescription drugs for selected disease states without a copayment. Disease states currently covered by the program include high blood pressure, high cholesterol, cardiovascular disease, congestive heart failure, coronary artery disease and diabetes. Certain lower-cost traditional test strips and other diabetic supplies are also included in the copay waiver program. These lower-cost diabetic supplies are currently offered to members at the generic copayment. Tier 2 preferred brand continuous glucose monitors, insulin pumps and their supplies are offered to members at the Tier 2 copayment and are eligible for the copay waiver program and the generic copayment applies. Tier 3 non-preferred brand products are not eligible for the No-Pay Copay program and the Tier 3 copayment applies. A list of products eligible for the copay waiver is included in Part 8 of this RFP. Members qualify for the program on an annual basis. By completing certain activities, they can receive certain generic drugs for the remainder of the current year and for next year. Some qualifying events are required to be completed on an annual basis. Participants must requalify each year to continue receiving the copay waiver. For participants enrolled in the Savings Plan, there is no patient liability at the point of sale. The copay waiver applies at both retail and mail-order pharmacies. Enrollment data for the No-Pay Copay program will be transmitted to the Contractor on a weekly basis from the Plan’s third-party medical claims administrator or any successor. The Contractor is responsible for loading the eligibility files prior to the effective date of the copay waiver so claims will process correctly. Effective dates for the copay waiver must be visible to PEBA Customer Service staff when viewing the Contractor’s system. The Contractor shall cooperate with PEBA and the Plan’s third-party medical claims administrator or any successor in the ongoing development, marketing, enhancement and operation of this program and any new health or wellness initiatives that affect prescription drug benefits offered by PEBA. As of October 2024, there are 1,515 members enrolled in the No-Pay Copay program.  A complete list of prescription drugs eligible for the No-Pay Copay program in 2024 is provided in Attachment 8 – 2024 Combined No-Pay Copay Drug List.","Select one"]
["Q-32","The Contractor shall possess the capability to administer the federally defined member Maximum Out-of- Pocket (MOOP) in an ACA-compliant plan in real time, or at a minimum near real time, in coordination with the State Health Plan’s third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, or any successor. This capability shall entail transmitting to the pharmacy the correct patient copayment due at that exact time if the patient is a member of a plan with an applicable MOOP. This duty will require real time coordination with the third-party medical claims administrator. The MUSC Health Plan is a non-grandfathered ACA-compliant plan with a MOOP currently in force, and the Contractor shall prepare as if the other state-sponsored plans may be non-grandfathered ACA-compliant effective at any time during the term of this Contract.","Select one"]
["Q-33","The Contractor may propose any innovative arrangements or programs that promote cost containment, quality, and efficiency in drug utilization. Costs for any such programs are to be included in the fixed administrative fee.","Select one"]
["Q-34","Describe how you will work with PEBA to propose and implement any innovative arrangements that promote cost containment, quality, and efficiency in drug utilization and how you will ensure that these programs are applicable to PEBA members."]
["Q-35","PEBA maintains a direct contract network with all hospitals and the vast majority of physicians in South Carolina. PEBA is seeking innovative methods to leverage those resources to manage cost and utilization. How would you propose to use the direct contract provider mechanism to manage prescription drug cost and utilization?"]

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[]
[]
[]
[{"$f":"'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2b: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["B.  PHARMACY NETWORK MANAGEMENT"]
["Q-1","The Contractor shall market, develop, organize, implement, operate and maintain a network of participating pharmacies (the “pharmacy network” or “network”). While PEBA understands that contracts are between the PBM and pharmacies, the PBM must work toward maximizing participation to ensure a successful and robust network.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"The Contractor shall contact all retail pharmacy chains, PEBA-defined locally owned independent pharmacies and nursing home pharmacies operating in South Carolina to solicit their participation in the pharmacy network. PEBA desires the maximum participation by all willing pharmacies, whether independent or national chain, and the greatest geographical coverage for the network within the state, including rural areas.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"The Contractor shall extend the opportunity of network participation to any willing retail pharmacies and pharmacy chain stores located in other states to enable State Health Plan Members who work or reside outside the state to have access to the pharmacy network.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-4"},"a.) Describe, in detail, how you would extend the opportunity of network participation to all retail pharmacy chains, independent pharmacies and nursing home pharmacies operating in South Carolina as well as to any willing retail pharmacies and pharmacy chain stores located in other states."]
[null,"b.) Describe, in detail, the solicitation materials you would use for distribution to all pharmacies in South Carolina."]
[null,"c.) Provide a sample of the solicitation materials you would use for distribution to all pharmacies in South Carolina.","Please label as \"Tab A-2b: Sample Pharmacy Solicitation Materials\"."]
[{"$f":"+\"Q-\"&RIGHT(A16,1)+1","v":"Q-5"},"a.) Describe how you will verify that pharmacies entering the network maintain the necessary federal and state licenses and permits required by law."]
[null,"b.) Describe how you will verify that pharmacies entering the network maintain adequate insurance for claims arising out of that pharmacy."]
[null,"c.) Describe how you will verify that pharmacies entering the network will identify and notify PEBA of any pharmacies which, in the opinion of the Contractor, do not meet minimum professional requirements or business standards for inclusion in the network."]
[{"$f":"+\"Q-\"&RIGHT(A19,1)+1","v":"Q-6"},"Describe the process used by your organization to verify that network pharmacies charge the applicable coinsurance or copayment to Members at the point of sale."]
[{"$f":"+\"Q-\"&RIGHT(A22,1)+1","v":"Q-7"},"Describe, in detail, your plan for conducting audits of network pharmacies to ensure compliance with network contract provisions."]
[{"$f":"+\"Q-\"&RIGHT(A23,1)+1","v":"Q-8"},"List the elements of your various audit programs.  Include frequency of the audit for each element and the audit method."]
[null,"a.) Type of Audit"]
[null,"b.) Frequency "]
[null,"c.) Method"]
[null,"a.) Type of Audit"]
[null,"b.) Frequency "]
[null,"c.) Method"]
[null,"a.) Type of Audit"]
[null,"b.) Frequency "]
[null,"c.) Method"]
[null,"a.) Type of Audit"]
[null,"b.) Frequency "]
[null,"c.) Method"]
[{"$f":"+\"Q-\"&RIGHT(A24,1)+1","v":"Q-9"},"Provide the results of your field audit programs for calendar years 2022, 2023 and 2024."]
[null,2022]
[null,"a.) Audits completed as a percent of all contracted pharmacies."]
[null,"b.) Pharmacies put on probation as a percent of all contracted pharmacies."]
[null,"c.) Pharmacies terminated as a percent of all contracted pharmacies."]
[null,"d.) Recovery (in dollars) as a percent of total book of business drug spend."]
[null,2023]
[null,"a.) Audits completed as a percent of all contracted pharmacies."]
[null,"b.) Pharmacies put on probation as a percent of all contracted pharmacies."]
[null,"c.) Pharmacies terminated as a percent of all contracted pharmacies."]
[null,"d.) Recovery (in dollars) as a percent of total book of business drug spend."]
[null,2024]
[null,"a.) Audits completed as a percent of all contracted pharmacies."]
[null,"b.) Pharmacies put on probation as a percent of all contracted pharmacies."]
[null,"c.) Pharmacies terminated as a percent of all contracted pharmacies."]
[null,"d.) Recovery (in dollars) as a percent of total book of business drug spend."]
[{"$f":"+\"Q-\"&RIGHT(A37,1)+1","v":"Q-10"},"How are audit recoveries pro-rated back to clients?"]
[{"$f":"+\"Q-\"&RIGHT(A53,2)+1","v":"Q-11"},"a.) Describe, in detail, the contract between the pharmacies and the Offeror, including the terms and conditions the contract will contain."]
[null,"b.) Please provide a sample contract between the pharmacy and the Offeror.","Please label as \"Tab A-2b: Sample Contract\"."]
[{"$f":"+\"Q-\"&RIGHT(A54,2)+1","v":"Q-12"},"Will you solicit non-participating pharmacies on behalf of PEBA?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A56,2)+1","v":"Q-13"},"a.) Describe how you would advise PEBA on your progress to obtain network participation of the largest number of pharmacies covering the greatest geographical area of the State."]
[null,"b.) How frequently will you provide PEBA with an update of your network participation efforts?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A57,2)+1","v":"Q-14"},"The Contractor shall provide representatives to make personal contact with the pharmacy provider community to communicate Plan rules, benefits, changes and claims filing procedures, as well as related pharmacy issues. All material distributed to providers is subject to approval by PEBA’s Insurance Policy and Communications departments.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A59,2)+1","v":"Q-15"},"The Contractor or its subcontractor shall provide home delivery pharmacy services. Any program to encourage use of the home delivery shall not be implemented by the Contractor without the express approval of PEBA’s Executive Director or their designee(s).","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A60,2)+1","v":"Q-16"},"How often does the Offeror pay locally owned pharmacies on average?"]
["HOME DELIVERY PHARMACY MANAGEMENT"]
[{"$f":"+\"Q-\"&RIGHT(A61,2)+1","v":"Q-17"},"Where is the primary home delivery facility location you propose for PEBA?"]
[{"$f":"+\"Q-\"&RIGHT(A63,2)+1","v":"Q-18"},"What are the days and hours of operation for this facility?"]
[{"$f":"+\"Q-\"&RIGHT(A64,2)+1","v":"Q-19"},"a.) Is this facility owned and operated by your organization?","Select one"]
[null,"b.) If so, are purchase discounts passed along to the purchaser or kept as margin by the PBM?"]
[{"$f":"+\"Q-\"&RIGHT(A65,2)+1","v":"Q-20"},"a.) Total number of home delivery service centers as of December 31, 2024."]
[null,"b.) Percent of capacity at which the home delivery service centers are functioning."]
[{"$f":"+\"Q-\"&RIGHT(A67,2)+1","v":"Q-21"},"a.) What was the average daily number of prescriptions filled during the period October 1, 2023 through September 30, 2024?"]
[null,"b.) Does this represent an increase or decrease  in volume from the previous year?","Select one"]
[null,"c.) If this represents an increase or decrease from the previous year, by how much did the average daily number of prescriptions change as a percent?"]
[{"$f":"+\"Q-\"&RIGHT(A69,2)+1","v":"Q-22"},"What is the estimated daily capacity of the proposed facility as of December 31, 2024?"]
[{"$f":"+\"Q-\"&RIGHT(A72,2)+1","v":"Q-23"},"Provide the average number of clinicians/pharmacists for the following:"]
[null,"Pharm D."]
[null,"Full-time"]
[null,"Part-time"]
[null,"Registered Pharmacist"]
[null,"Full-time"]
[null,"Part-time"]
[null,"Pharmacy Technicians"]
[null,"Full-time"]
[null,"Part-time"]
[null,"Other clinical staff"]
[null,"Full-time"]
[null,"Part-time"]
[{"$f":"+\"Q-\"&RIGHT(A73,2)+1","v":"Q-24"},"a.) Describe your process for ordering refills by mail."]
[null,"b.) Provide a sample refill order form ","Label as \"Tab A-2b: Sample Refill Order Form\"."]
[{"$f":"+\"Q-\"&RIGHT(A86,2)+1","v":"Q-25"},"a.) Describe your process for ordering refills by phone."]
[null,"b.) What percentage of fills are ordered by phone?"]
[null,"c.) How far in advance can Members order a refill?"]
[{"$f":"+\"Q-\"&RIGHT(A88,2)+1","v":"Q-26"},"a.) Describe what quality controls are in place to ensure accurate dispensing of prescriptions."]
[null,"b.) How many levels of review take place and who conducts the reviews?"]
[{"$f":"+\"Q-\"&RIGHT(A91,2)+1","v":"Q-27"},"Describe on-line integration, if any, with retail pharmacies to ensure non-duplication and to identify potential adverse interactions."]
[{"$f":"+\"Q-\"&RIGHT(A93,2)+1","v":"Q-28"},"a.) What are your contingency plans and procedures for providing backup service in the event of strike, natural disaster, or backlog?"]
[null,"b.) What  are your contingency plans and procedures for providing backup service in the event of a total system failure?"]
[{"$f":"+\"Q-\"&RIGHT(A94,2)+1","v":"Q-29"},"a.) How often do you switch generic manufacturers for particular products? "]
[null,"b.) How are Members notified of the switch?"]
[{"$f":"+\"Q-\"&RIGHT(A96,2)+1","v":"Q-30"},"Provide your claim processing standards versus actual results for 2022 and 2023 for the following:"]
[null,"Turnaround time for routine prescriptions"]
[null," • Claim processing standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[null,"Turnaround time for prescriptions requiring intervention"]
[null," • Claim processing standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[null,"Prescription accuracy"]
[null," • Claim processing standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[{"$f":"+\"Q-\"&RIGHT(A98,2)+1","v":"Q-31"},"Please list the top ten manufacturers of generic medications for your book of business by volume for time period October 1, 2023 through September 30, 2024."]
[null,"1. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"2. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"3. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"4. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"5. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"6. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"7. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"8. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"9. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[null,"10. Manufacturer Name"]
[null,"October 1, 2023 - September 30, 2024 volume (in units)"]
[{"$f":"+\"Q-\"&RIGHT(A111,2)+1","v":"Q-32"},"a.) Are on-site audits performed at your mail service pharmacies? "]
[null,"b.) Describe the frequency and types of audits performed. "]
[null,"c.) Is the Home Delivery Service Pharmacy that will support PEBA home delivery program subjected to the same audit programs as your Retail Network?"]
[{"$f":"+\"Q-\"&RIGHT(A132,2)+1","v":"Q-33"},"Please describe the process for notifying customers of:"]
[null,"a.) Expiration date of their prescription"]
[null,"b.) Their next refill date and the number of refills"]
[null,"c.) Prescriptions not on formulary"]
[null,"d.) Generic substitution availability"]
[{"$f":"+\"Q-\"&RIGHT(A135,2)+1","v":"Q-34"},"a.) Describe your system of providing patient advisory information with prescriptions filled, including next refill date and the number of refills."]
[null,"b.) What percentage of prescriptions receives a patient information supplement?"]
[null,"c.) Provide sample materials of your patient advisory information.","Please label as \"Tab A-2b: Patient Advisory Information\"."]
[{"$f":"+\"Q-\"&RIGHT(A140,2)+1","v":"Q-35"},"a.) How is the member billed (i.e. before or after the prescription is filled)?"]
[null,"b.) How does the member know which copay applies?"]
[{"$f":"+\"Q-\"&RIGHT(A143,2)+1","v":"Q-36"},"Does the Offeror e-mail:"]
[null,"a.) Refill reminders","Select one"]
[null,"b.) Savings intervention opportunity messages","Select one"]
[null,"c.) COB messages","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A145,2)+1","v":"Q-37"},"The Contractor or its subcontractor shall allow for full-service dispensing of medications by South Carolina based locally owned independent pharmacies that have earned accreditation as a specialty pharmacy by an acceptable accreditation body, as well as pharmacies it owns or operates. Members in the Commercial Plan are required to purchase specialty medications at a specialty pharmacy network pharmacy.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A149,2)+1","v":"Q-38"},"The Contractor shall offer a retail maintenance pharmacy network, similar in respects to the retail maintenance networks currently in place, that allows Members in the Commercial and EGWP plans options to purchase 90-day supplies of prescription drugs at local retail pharmacies for the same copayment available through the home delivery pharmacy. Members in the Savings Plan pay the full allowed amount for prescription drugs.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A150,2)+1","v":"Q-39"},"Please describe your company's capability to administer a retail 90 day supply network, which allows Members in the Commercial and EGWP plans options to purchase 90-supplies at retail locations with the same benefit as the home delivery pharmacy."]
[{"$f":"+\"Q-\"&RIGHT(A151,2)+1","v":"Q-40"},"The Contractor shall invoice PEBA acquisition costs plus a dispensing fee for all prescriptions filled by home delivery pharmacies with whom it or its subcontractor are affiliated. Contractor shall provide documentation as to its internal processes and controls it has deployed to substantiate acquisition costs billed to PEBA. Contractor agrees it will provide a 10% transaction sample of prescriptions filled by home delivery pharmacies (selected by PEBA) to validate acquisition costs on no less than an annual basis. Data provided by the Contractor for this purpose will be linkable with a transaction identifier to the claims data extract used for payment substantiation.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A152,2)+1","v":"Q-41"},"The Contractor shall offer a Specialty Pharmacy Network for the Commercial Plan only, similar in respects to the specialty pharmacy network currently in place. The specialty pharmacy network should include the Contractor’s specialty pharmacy and South Carolina locally-based independent pharmacies that have earned or are in the process of accreditation in specialty pharmacy. Members in the Commercial Plan are required to purchase specialty medications at a specialty pharmacy network pharmacy. ","Select one"]
["SPECIALTY PHARMACY (Biotech and Injectables)"]
[{"$f":"+\"Q-\"&RIGHT(A153,2)+1","v":"Q-42"},"a.) Does your organization offer an integrated specialty program? ","Select one"]
[null,"b.) If yes, describe the operations of the program and include elements describing your case and care management abilities."]
[{"$f":"+\"Q-\"&RIGHT(A155,2)+1","v":"Q-43"},"a.) Does your organization own a specialty pharmacy?","Select one"]
[null,"b.) If yes, are purchase discounts passed along to the plan or kept as margin by the PBM?"]
[{"$f":"+\"Q-\"&RIGHT(A157,2)+1","v":"Q-44"},"Please provide a copy of your proposed Affiliated Pharmacy Specialty drug list in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and  aquisition cost per metric quantity. (Assume a dispense date of December 1, 2024.)","Please label as \"Tab A-2b: Affiliated Pharmacy Specialty Drug List - Commercial Plan\"."]
[{"$f":"+\"Q-\"&RIGHT(A159,2)+1","v":"Q-45"},"Please provide a copy of your proposed Retail Pharmacy Specialty drug list in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and price per metric quantity. (Assume a dispense date of December 1, 2024.)","Please label as \"Tab A-2b: Retailed Pharmacy Specialty Drug List - Commercial Plan\"."]
[{"$f":"+\"Q-\"&RIGHT(A160,2)+1","v":"Q-46"},"a.) Is there separate pricing for injectable and biotech products?","Select one"]
[null,"b.) If yes, please provide a separate fee schedule."]
[{"$f":"+\"Q-\"&RIGHT(A161,2)+1","v":"Q-47"},"a.) How long has your organization had this program in place? "]
[null,"b.) How many patients do you currently provide services to?"]
[{"$f":"+\"Q-\"&RIGHT(A163,2)+1","v":"Q-48"},"Please provide a client reference for this program."]
[null,"a.) Organization"]
[null,"b.) Contact Name"]
[null,"c.) Title"]
[null,"d.) Telephone"]
[{"$f":"+\"Q-\"&RIGHT(A165,2)+1","v":"Q-49"},"a.) Describe the process to address exclusivity or limited distribution scenario."]
[null,"b.) Please provide (in Excel format) a complete list of NDC codes (11 digits, unformatted) for drugs you consider limited distribution drugs (LDD) and please indicate which NDC's are considered exclusive to you, the Offeror. This list should be based on what would have been in place if you were administering PEBA’s prescription drug benefits on January 1, 2025.","Please label as \"Tab A-2b: Limited Distribution Drug List\"."]
[null,"c.) Please describe in detail the process that you would use to maintain and share with PEBA the LDD NDC list during contract performance."]
[{"$f":"+\"Q-\"&RIGHT(A170,2)+1","v":"Q-50"},"Do you provide any of the following programs?"]
[null,"a.) a package recovery program","Select one"]
[null,"b.) a vial/assay management program","Select one"]
[null,"c.) a ready to inject program","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A173,2)+1","v":"Q-51"},"Do you report on compliance and adherence to therapy as part of your standard reporting package?"]
[{"$f":"+\"Q-\"&RIGHT(A177,2)+1","v":"Q-52"},"Please describe what you anticipate, both for unit and aggregate costs, to be the top ten most costly specialty drugs in the next three years for your customers."]
[{"$f":"+\"Q-\"&RIGHT(A178,2)+1","v":"Q-53"},"What is your net annual enterprise forecasted specialty drug claim trend factor for each of the following calendar years?"]
[null,"a.) CY 2026"]
[null,"b.) CY 2027"]
[{"$f":"+\"Q-\"&RIGHT(A179,2)+1","v":"Q-54"},"Please describe your company’s strategy to effectively manage cost of specialty drugs while ensuring access for those needing those services, either solely on the prescription plan and/or in collaboration with the medical plan vendor."]
[{"$f":"+\"Q-\"&RIGHT(A182,2)+1","v":"Q-55"},"Please describe your company's strategy to effectively manage costs associated with genetic therapies."]
[{"$f":"+\"Q-\"&RIGHT(A183,2)+1","v":"Q-56"},"Please describe how your company administers specialty pharmacy claims dispensed at non-company affiliated pharmacy locations"]
[{"$f":"+\"Q-\"&RIGHT(A184,2)+1","v":"Q-57"},"The Contractor shall maintain and apply generally accepted medical standards and practices to determine whether prescribed drug treatments provided to Members are consistent with generally accepted criteria.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A185,2)+1","v":"Q-58"},"The Contractor shall demonstrate on or before October 1, 2025, the networks can commence operation on January 1, 2026.","Select one"]
["Q-59","PEBA or its authorized agent shall have the right to review copies of the contract, either onsite or virtually,  between pharmacies and the PBM. Contractor agrees it will provide a 10% sample of prescription transactions filled by retail pharmacies (selected by PEBA) to validate passthrough reimbursement on no less than an annual basis. Data provided by the Contractor for this purpose will be linkable with a transaction identifier to the claims data extract used for payment substantiation.","Select one"]
["Q-60","The Contractor must maintain a positive working relationship with the locally owned pharmacy community in South Carolina and be accessible and responsive to the pharmacies regarding operational issues that may arise.","Select one"]
["Q-61","Please describe how you will maintain a positive working relationship with the locally-owned pharmacy community in South Carolina and be accessible and responsive to the pharmacies regarding operational issues that may arise."]
["Q-62","Contractor shall not prohibit a South Carolina based locally owned pharmacy from communicating with PEBA regarding issues related to PEBA.","Select one"]

{"sheet":"A-2c Service Questionnaire","index":5,"n_rows":67,"n_cols":3,"rows_kept":67,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2c: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["C.  CLAIMS PROCESSING and PAYMENT"]
["Q-1","The Contractor shall process all prescription drug claims incurred by eligible Participants on and after January 1, 2026, and during the entire term of the Contract, determine whether the claim is payable and pay the claim subject to applicable Plan provisions. Following termination of this Contract, the Contractor shall continue to process all prescription drug claims for the Plan that were incurred during the term of the Contract for a period of twelve (12) months at no additional charge.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"Describe, in detail, your approach to providing pharmacy claims processing and adjudication."]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"Describe the adjudication platforms (hardware, software and communications) that would be used to perform retail and home delivery prescription claim processing "]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-4"},"a.) Does the Offeror own the adjudication platforms (hardware, software, and communications) used to perform the retail and home delivery prescription claims processing?","Select one"]
[null,"b.) If no, please explain."]
[{"$f":"+\"Q-\"&RIGHT(A16,1)+1","v":"Q-5"},"a.) Does the Offeror own the code that is used to build all system platforms that govern the claim adjudication functions?  (These platforms include, but are not limited to, retail and home delivery adjudication, eligibility systems, plan design systems and reporting systems.)","Select one"]
[null,"b.) If no, please explain."]
[{"$f":"+\"Q-\"&RIGHT(A18,1)+1","v":"Q-6"},"The Contractor, under the Savings Plan, shall calculate the allowance at the point of sale and inform the pharmacy, which will collect 100% of the allowance from the patient until the Savings Plan deductible is met and coinsurance until the coinsurance maximum is met. The Contractor shall transmit in real time, or near-real time, the allowance electronically to the Plan’s third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, or any successor for application of deductible credit, and if appropriate, payment of claim to the Participant.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A20,1)+1","v":"Q-7"},"a.) Describe your capability of separately processing prescription drug claims for members enrolled in a Health Savings Account qualified plan and transmitting information to the Plan's medical claims administrator (currently, Blue Cross Blue Shield of South Carolina).  "]
[null,"b.) Describe the frequency at which you are able to transmit prescription drug claims data to the Plan's medical claims administrator (e.g. real time, hourly, daily, weekly, etc.)"]
[{"$f":"+\"Q-\"&RIGHT(A21,1)+1","v":"Q-8"},"a.) Describe your capability of separately processing prescription drug claims for members and transmitting information to the Plan's medical claims administrator (currently, Blue Cross Blue Shield of South Carolina) in order to comply with federal requirements, including combined out of pocket limits."]
[null,"b.) Describe the frequency at which you are able to transmit prescription drug claims data to the Plan's medical claims administrator (e.g. real time, hourly, daily, weekly, etc.)"]
[{"$f":"+\"Q-\"&RIGHT(A23,1)+1","v":"Q-9"},"The Contractor shall implement plan modifications as required under the Medicare Modernization Act (MMA), also known as the Prescription Drug, Improvement and Modernization Act of 2003 (DIMA), or for compliance with any other federal requirements.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A25,1)+1","v":"Q-10"},"The Contractor shall provide an online data link between each participating network pharmacy and the PBM that permits the pharmacist, prior to the completion of the transaction, to:"]
[null,"a.) Verify patient’s eligibility;","Select one"]
[null,"b.) Receive the current pricing information on the prescription drug;","Select one"]
[null,"c.) Provide purchase approval to the participating pharmacy by means of an online system;","Select one"]
[null,"d.) Conduct concurrent drug utilization reviews to identify and notify the participant of any drug treatment that is potentially harmful, unnecessary, non-covered, or requires prior authorization;","Select one"]
[null,"e.) Receive information on lower cost alternatives from the preferred drug list maintained by the PBM or lower cost generic alternatives, if appropriate;","Select one"]
[null,"f.) Inform the participant of all information that indicates that the prescription may be inappropriate for the individual; and","Select one"]
[null,"g.) Receive any information maintained by the PBM on therapeutic contraindications or potential problems from use of the drug prescribed.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A26,2)+1","v":"Q-11"},"a.) Describe the online data link between each participating pharmacy and the Offeror."]
[null,"b.) Provide a list of items the online data link will allow the pharmacist to review prior to completion of a transaction."]
[{"$f":"+\"Q-\"&RIGHT(A34,2)+1","v":"Q-12"},"Identify which of the following edits are performed at the point of service:"]
[null,"a.) Ineligible participant","Select one"]
[null,"b.) Ineligible drug","Select one"]
[null,"c.) Incorrect AWP","Select one"]
[null,"d.) UCR input","Select one"]
[null,"e.) Duplicate Rx","Select one"]
[null,"f.) Refill too soon","Select one"]
[null,"g.) Incorrect dosage","Select one"]
[null,"h.) Rx splitting","Select one"]
[null,"i.) Drug interactions","Select one"]
[null,"j.) Over utilization","Select one"]
[null,"k.) Under utilization","Select one"]
[null,"l.) COB","Select one"]
[null,"m.) Benefit maximums for certain drug types","Select one"]
[null,"n.) Drug is inappropriate for the patient due either to age or sex","Select one"]
[null,"o.) Other (specify)"]
[{"$f":"+\"Q-\"&RIGHT(A36,2)+1","v":"Q-13"},"The Contractor shall provide the necessary claim forms that can be submitted directly to the Contractor by State Health Plan Members for processing after making a prescription drug purchase at a network pharmacy in which the pharmacist was unable to verify the Member's eligibility. The drug claim form shall provide a disclaimer statement indicating reimbursement is not guaranteed, and the Contractor will review the claim, subject to limitations, exclusions and other provisions of the State Health Plan. In plan year 2023, there were 2,127 prescriptions adjudicated through the paper claims process. In plan year 2024 (paid through October), there were 2,078 prescriptions adjudicated through the paper claims process.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A52,2)+1","v":"Q-14"},"The Contractor shall generate and mail a check, as required, as well as an explanation of benefits (EOB) or denial notice for Member submitted claims and a remittance advice for provider submitted claims. The form of the EOB, denial notice and remittance advice are subject to PEBA’s approval.","Select one"]
["Q-15","The Contractor shall maintain a history of all prescription drug claims paid at both retail and home delivery. The Contractor shall maintain no less than twenty-four (24) months of claims history online.","Select one"]
["Q-16","The Contractor shall identify areas of potential claims payment discrepancies and take corrective actions. In the case of a Plan or member overpayment, refunds should be issued within thirty-one (31) days of discovery. The Contractor shall notify PEBA if Member or provider fraud is discovered and shall pursue all legal means available to recover fraudulent claim payments to a Member or provider.","Select one"]
["Q-17","The Contractor shall perform reviews, such as verification of services billed, and notify PEBA if covered person fraud, provider fraud or improper provider billing practices were discovered.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A56,2)+1","v":"Q-18"},"Describe how you would notify PEBA if covered person fraud, provider fraud or improper provider billing practices were discovered."]
["Q-19","The Contractor shall identify any instance where coordination of benefits applies and take appropriate action to recover claims payments or other costs. The Contractor shall be responsible for capturing and enforcing coordination of benefits at the point of sale, as provided by PEBA. The Contractor shall report Plan savings as a result of coordination of benefits.","Select one"]
["Q-20","a.) Describe, in detail, how you will enforce coordination of benefits at the point of sale."]
[null,"b.) Describe how you will cooperate with PEBA to obtain information on other health insurance for covered persons."]
[null,"c.) Describe how you will report plan savings as a result of coordination of benefits."]
[{"$f":"+\"Q-\"&RIGHT(A59,2)+1","v":"Q-21"},"How are out-of-network claims processed?"]
[{"$f":"+\"Q-\"&RIGHT(A62,2)+1","v":"Q-22"},"The Contractor shall coordinate at a minimum daily with the third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, or any successor in the application of payments for outpatient infertility treatment, and with any other Plan payment limits that include both medical and pharmacy claims payments. Except in isolated instances, the PBM processes all drug claims. The Plan pays a total lifetime maximum of $15,000 for infertility treatment. Prescription drugs for treatment of infertility are subject to a 30% coinsurance payment under both the Standard Plan and Savings Plan. This expense does not apply to the $3,000 per person prescription copayment maximum under the Standard Plan. It does apply to the Savings Plan deductible. The 70% Plan payment for prescription drugs for infertility treatments applies to the $15,000 maximum lifetime payment for infertility treatments. In the Savings Plan, the Contractor shall adjudicate prescription claims and transmit them to the third-party medical claims administrator, who in turn applies deductible credit.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A63,2)+1","v":"Q-23"},"The Contractor shall provide access to pharmacy and medical advisors, and pharmaceutical texts, literature, pharmacy care standards and other materials as needed for consideration and determination of claims, and for review of disputed claims or appeals of denials in whole or in part.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A64,2)+1","v":"Q-24"},"The Contractor shall provide an internal appeals process for all claim denials in accordance with Article 12 of the State Health Plan (available at www.peba.sc.gov/sites/default/files/plan_of_benefits.pdf). If any part of a claim is denied by the Contractor and the Member requests a review within six months after receiving notice of the decision from the Contractor, the Contractor must provide a first and second review of the decision. If the Contractor continues to deny any part of the claim, the Member can appeal the Contractor’s decision to PEBA. The Contractor will cooperate with PEBA’s appeals process for disputed claims, providing personnel to supply complete, accurate, timely and legible documentation as necessary to support the Contractor’s decisions and assist PEBA in its review. The documentation shall include at a minimum: (a) the determination, which should reflect sufficient understanding of the information relevant to the claim; reference to the information submitted by the Member; analysis of why the claim was denied; and reference to the applicable Plan language, standards and determinations of the U.S. Food and Drug Administration, and utilization review and management standards established by the Contractor for the Plan; (b) all documentation submitted by the Member regarding the claim; (c) a copy of the Plan language, standards and determinations of the U.S. Food and Drug Administration, utilization review and management standards, and any other standards relied upon by the Contractor; and (d) documentation of contacts with the Member, whether via email, telephone, or letter, regarding the claim. At all times, the Contractor shall provide access to pharmacy and medical advisors for further review of disputed claims or appeals as needed by PEBA. If PEBA denies any part of a claim and the Member appeals to the courts, the Contractor will be responsible for providing independent legal counsel to represent PEBA and defend the denial. The legal representation is subject to PEBA’s approval, and PEBA may at any time during the Contract, in its sole discretion, for any reason or no reason at all, reject the offered counsel and require new counsel be retained on its behalf. The legal representation must include attorneys experienced in employee benefits defense or appearance before the South Carolina Administrative Law Court.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A65,2)+1","v":"Q-25"},"Please describe your appeals process including your brand/generic appeals process."]
[{"$f":"+\"Q-\"&RIGHT(A66,2)+1","v":"Q-26"},"Describe how you will cooperate with the operation of PEBA appeals process for disputed claims."]

{"sheet":"A-2d Service Questionnaire","index":6,"n_rows":55,"n_cols":3,"rows_kept":55,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2d: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["D.   CUSTOMER SERVICE"]
["Q-1","The Contractor shall provide dedicated customer service representatives trained on the specific features of the benefits of the Commercial and EGWP plans to respond to written and telephone inquiries from Members, providers and employers; to answer questions and provide assistance with accessing benefits; and to resolve claims payment problems. Customer service representatives must be knowledgeable about all Plans offered by PEBA and able to assist members with questions regardless of the Plan in which they are enrolled.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"The Contractor shall assist Members, providers and employers via dedicated toll-free customer service telephone line(s) available during the hours of 8 a.m. to 5:30 p.m., EST, and on the same business days as PEBA. The Contractor will be required to demonstrate by September 15, 2025, it has established and staffed telephone lines.","Select one"]
["Q-3","The Contractor shall provide PEBA-dedicated representatives with a manager readily available during business hours (Eastern Standard Time) and on the same business days as PEBA to take calls from PEBA’s customer service representatives and managers. The Contractor’s representatives shall be capable of responding to all inquiries and be able to resolve issues of eligibility, enrollment, claims and any other administrative matter presented to them. The Contractor shall provide an escalation process of problem resolution to PEBA customer service managers. This process shall involve Contractor management representatives who have authority to resolve more complex issues. The Contractor will be required to demonstrate it has established and staffed telephone lines by September 15, 2025.","Select one"]
["Q-4","The Contractor shall provide callers with a survey instrument at the end of each call or online inquiry to gauge customer satisfaction (e.g., wait time, courtesy of staff, knowledge of product, willingness to assist, problem resolved/question answered) with the Contractor’s call center.","Select one"]
["Q-5","The Contractor shall conduct an annual Member Satisfaction Survey to gauge satisfaction with the Contractor in the previous year. The Member Satisfaction Survey must be prior approved by PEBA. Results must be submitted to PEBA’s Procurement Officer by February 15 of each year.","Select one"]
["Q-6","The Contractor shall ensure the confidentiality of subscriber information in responding to all inquiries.","Select one"]
["Q-7","a.) Does the Offeror own and operate the customer service department that will be used to support PEBA?","Select one"]
[null,"b.) If no, please explain."]
[null,"c.) Describe the customer service unit (organization, staffing and services) that would handle PEBA's account."]
[{"$f":"+\"Q-\"&RIGHT(A19,1)+1","v":"Q-8"},"Describe how your customer service representatives will be dedicated to PEBA."]
[{"$f":"+\"Q-\"&RIGHT(A22,1)+1","v":"Q-9"},"Briefly describe the training that each associate receives to prepare to manage the PEBA benefit? Include length of time it takes to go from training to CSR."]
[{"$f":"+\"Q-\"&RIGHT(A23,1)+1","v":"Q-10"},"a.) Are there any scheduled changes to any of the CSR support platforms? ","Select one"]
[null,"b.) If so, include description of old and new platform along with a timeline of when the changes will be implemented."]
[{"$f":"+\"Q-\"&RIGHT(A24,2)+1","v":"Q-11"},"How will the customer service unit be staffed?"]
[{"$f":"+\"Q-\"&RIGHT(A26,2)+1","v":"Q-12"},"What are customer service hours of operation?"]
[{"$f":"+\"Q-\"&RIGHT(A27,2)+1","v":"Q-13"},"What happens to after-hours calls?"]
[{"$f":"+\"Q-\"&RIGHT(A28,2)+1","v":"Q-14"},"How do you track and monitor phone service on an account-specific basis?"]
[{"$f":"+\"Q-\"&RIGHT(A29,2)+1","v":"Q-15"},"Provide your  phone service standard versus actual results for calendar years 2022 and 2023."]
[null,"Average speed to answer"]
[null," • Phone service standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[null,"Call abandonment rate"]
[null," • Phone service standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[null,"Percent of calls solved without requiring a call back"]
[null," • Phone service standard"]
[null," • 2022 Actual"]
[null," • 2023 Actual"]
[{"$f":"+\"Q-\"&RIGHT(A30,2)+1","v":"Q-16"},"Does your CSR system support TTY, TDY technologies?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A43,2)+1","v":"Q-17"},"a.) Can your customer services unit support non-English speaking members?","Select one"]
[null,"b.) If yes, please specify languages."]
[{"$f":"+\"Q-\"&RIGHT(A44,2)+1","v":"Q-18"},"a.) Do you expect to make major changes to the service organization (e.g. moving to a different location, merging units, etc)?","Select one"]
[null,"b.) If yes, please describe the changes."]
[{"$f":"+\"Q-\"&RIGHT(A46,2)+1","v":"Q-19"},"a.) Provide a copy of the latest after-call survey your organization has conducted.","Please label as \"Tab A-2d: Customer Satisfaction Survey\"."]
[null,"b.) How was the survey instrument developed?"]
[null,"c.) Do you use an independent outside vendor to conduct the survey? If so, who?"]
[null,"d.) Are survey results released to the public?"]
[null,"e.) How are respondents to the survey selected?"]
[null,"f.) What was the date of the last survey?"]
[null,"g.) What percentage of respondents were either very satisfied or satisfied with the services of your organization?"]
[{"$f":"+\"Q-\"&RIGHT(A48,2)+1","v":"Q-20"},"Are there tools available to Members who don’t register on your site?"]

{"sheet":"A-2e Service Questionnaire","index":7,"n_rows":34,"n_cols":3,"rows_kept":34,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
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[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2e: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["E.  COMMUNICATIONS AND TRAINING"]
["Q-1","The Contractor shall furnish communication information on the Prescription Drug Program to Members, employers, providers, the pharmaceutical community and PEBA that describes the features, operations and any changes of the Prescription Drug Program and increases awareness of the Program’s benefits and changes. Communications with PEBA, Members and employers will be undertaken to ensure that electronic data transfer, fax, telephone and hard copy transfer of information are accurate as determined by PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"The Contractor must have the capability to use a member’s Benefits Identification Number (BIN), that PEBA assigns and provides, to identify Prescription Drug Program members on identification cards, member letters and benefit statements.","Select one"]
["Q-3","The Contractor shall provide personalized member notification of start dates of new coverage reviews, and Plan changes, including but not limited to, prescription drug tier changes and exclusions. Provide personalized member notification of prior authorization expirations and home delivery pharmacy expirations. Communications should include at a minimum an initial and a reminder notification. The initial notification should be sent at least 60 days prior to the effective date of the change. The reminder notification should be sent at least 30 days prior to the effective date of the change. Member communication can include, but is not limited to, personalized letters or emails if the member has elected to receive electronic communication. Provide talking points to PEBA for customer service staff at least 60 days prior to the effective date of clinical rules and Plan changes. Talking points should include at a minimum information about the change, including member impact, what the change means to members and a summary of communications about the change.","Select one"]
["Q-4","The Contractor shall work collaboratively with PEBA’s Communications Department and Insurance Policy staff to develop an annual marketing plan to promote benefits of the Prescription Drug Program. Contractor should provide recommendations to meet the long-term and short-term goals. PEBA will produce the final marketing plans with input from the Contractor. All collateral the Contractor produces is subject to approval by PEBA prior to actual use. Materials may include, but are not limited to, content for targeted, digital campaigns (e.g., flyers and social media posts).","Select one"]
["Q-5","The Contractor shall provide at least one staff member with experience in marketing and communications. This staff member shall be assigned to the Contract. Provide personnel for monthly communications conference calls at which initiatives, campaigns and progress will be discussed. Recommend specific communications plans and goals in accordance with the overall management of the Prescription Drug Program during these calls. Reporting of general and targeted metrics and status updates, as well as operational updates, will be required. Other calls may be scheduled in addition to monthly calls to meet deadlines for campaigns.","Select one"]
["Q-6","The Contractor shall ensure all informational materials, letters, notices and collateral are cobranded with PEBA’s logo and the Contractor’s logo according to PEBA’s brand guidelines for vendors. The Contractor’s logo should reflect the relationship between PEBA and the Contractor with the use of a label such as “Administered by:”. The Contractor should follow other guidelines including size of logo, colors, typography and other styles as identified in the brand guidelines and should adhere to Associated Press style guidelines. All materials must be reviewed and approved by PEBA’s Communications Department prior to use.","Select one"]
["Q-7","The Contractor shall develop and distribute approved Member-specific customized communications materials and items. Information specific to a Member’s account shall be printed and mailed to the Member address on file unless the Member has elected a paperless delivery option. These include, but are not limited to, notification of benefits elections and changes to Members; appeal decision letters; explanations of benefits; and welcome packets, which include an identification card for all new Members. Welcome packets with the identification card must be printed and mailed. Notices and materials must be reviewed and approved by PEBA’s Communications Department prior to use. The templates for all appeals letters (letters involving the approval or denial of a provider’s or member’s request) must be customizable and approved by PEBA’s Communications Department and Insurance Appeals Division prior to use.","Select one"]
["Q-8","The Contractor shall maintain a secure, password-protected, transaction-enabled website specific to the Prescription Drug Program that allows Members, at a minimum, to access prescription drug ID cards, locate network pharmacies, price medications and check for clinical review requirements. Work with the third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, and any successor, to implement single sign-on capability from My Health Toolkit website to the Contractor’s website.","Select one"]
["Q-9","The Contractor shall provide a mobile app that allows Members, at a minimum, to access prescription drug ID cards, locate network pharmacies, price medications and check for clinical review requirements. Work with the third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, and any successor, to implement single sign-on capability from My Health Toolkit mobile app to the Contractor’s mobile app.","Select one"]
["Q-10","The Contractor shall provide a customized microsite that is accessible without entering a password that includes information specific to the Prescription Drug Program benefits and features. The microsite, and any software programs residing on the microsite, shall explain the benefits and value of the program and provide a current directory of all network pharmacies. Microsite content must be reviewed and approved by PEBA’s Communications Department prior to use, and it must not contain features or functionality not specific to and appropriate for this Contract.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A22,2)+1","v":"Q-11"},"The Contractor shall not conduct any mass paper or electronic mailings to Members or contact employers without the prior express permission of PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A23,2)+1","v":"Q-12"},"The Contractor shall provide materials and personnel, upon PEBA or employers’ request, to attend events to promote the benefits of the Prescription Drug Program and to inform Members of rules, updates, changes and features of the Prescription Drug Program, especially prior to and during the October open enrollment period. All materials distributed to employers, Members and eligible employees are subject to prior approval by PEBA’s Communication Department.","Select one"]
["Q-13","The Contractor shall provide personnel at PEBA’s Benefits at Work conference, if requested, should the agency host a conference.","Select one"]
["Q-14","Describe the informational materials that may be used to ensure all eligible Members are aware of the Prescription Drug Program. Provide examples of materials, such as flyers and social media posts, that may be used to communicate Program information to ensure all eligible Members are aware of and understand the Plan. "]
["Q-15","Describe your ability to customize communications for PEBA, including personalized Member notification letters, appeal decision letters, explanations of benefits and welcome packets. Provide examples that illustrate cobranding and customization."]
["Q-16","Describe the process by which you notify Members of start dates of new coverage reviews and Plan changes."]
["Q-17","a. Describe your experience in creating and delivering a marketing plan for a large public employer, including the outcomes. Provide an example."]
[null,"b. How do you determine what information to communicate?"]
[null,"c. How are the objectives and topics connected to improving quality and managing costs?"]
[{"$f":"+\"Q-\"&RIGHT(A29,2)+1","v":"Q-18"},"Provide a detailed description and screenshots of the secure, password-protected, transaction-enabled website you will use for the Prescription Drug Program. Detail the capability for customization."]
[{"$f":"+\"Q-\"&RIGHT(A32,2)+1","v":"Q-19"},"Provide a detailed description and screenshots of the secure, password-protected, transaction-enabled mobile app you will use for the Prescription Drug Program. Detail the capability for customization."]
[{"$f":"+\"Q-\"&RIGHT(A33,2)+1","v":"Q-20"},"Provide a detailed description and screenshots of the microsite you will use for the Prescription Drug Program that will be accessible without entering a password. Detail the capability for customization."]

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[]
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[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2f: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["F.  REPORTING"]
["Q-1","The Contractor shall submit regular reports detailing financial, Member services and administrative data by location and status. This data will support performance standards and associated guarantee monitoring, internal management reporting and other benefits activities.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"The Contractor shall provide in a format and on a basis acceptable to PEBA, standardized management reports, that include at a minimum the following reports and measures by Plan (Commercial Plan, EGWP Plan):","Select one"]
[null,"a.) Financial Performance Measures Reports including appropriate benchmarks:"]
[null,"  • Key prescription drug plan cost components"]
[null,"  • Key participation demographic cost components"]
[null,"  • Plan savings as a result of formulary management, rebates, EGWP subsidies, clinical programs, coordination of benefits or other cost containment initiatives"]
[null,"b.) Utilization Reports for claims processed by:"]
[null,"  • Drug type (brand, generic)"]
[null,"  • Specialty status (non-specialty, specialty)"]
[null,"  • Formulary status"]
[null,"  • Pharmacy type (retail, home delivery)"]
[null,"c.) Industry trends"]
[null,"d.) Operational performance:"]
[null,"  • Customer service call statistics"]
[null,"  • Web and other digital-use performance statistics"]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"List the reports and provide examples of the standard reporting package you will be delivering to PEBA.","Please label as \"Tab A-2f: Sample Standard Reporting Package\"."]
[{"$f":"+\"Q-\"&RIGHT(A28,1)+1","v":"Q-4"},"a.) Will you provide normative data against which PEBA can benchmark its plan? ","Select one"]
[null,"b.) What is the source of the data and what specific benchmark information will you provide?"]
[{"$f":"+\"Q-\"&RIGHT(A29,1)+1","v":"Q-5"},"The Contractor shall provide PEBA with access to an online query system for analysis of at a minimum prescription drug claims data related to:","Select one"]
[null,"a.) Individual claimants (subscriber type, member type, entity type, etc.);"]
[null,"b.) Prescription drug information;"]
[null,"c.) Pharmacy information;"]
[null,"d.) Therapeutic category;"]
[null,"e.) Prescriber information;"]
[null,"f.) Network information; and"]
[null,"g.) Utilization."]
[null,"In addition, provide an online management reporting system that offers customization and drill-down capabilities. These reports should include but are not limited to:","Select one"]
[null,"a.) Benchmark Reports;"]
[null,"b.) Key Performance Metrics;"]
[null,"c.) Specialty Drug Reports;"]
[null,"d.) Utilization Reports;"]
[null,"e.) Billing Reports;"]
[null,"f.) Lag Reports;"]
[null,"g.) Pharmacy Reports;"]
[null,"h.) Prescriber Reports; and"]
[null,"i.) Prior Authorization Reports."]
[null,"Data in online query system should be available to PEBA no later than ten (10) calendar days at the end of a reporting period.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A31,1)+1","v":"Q-6"},"Describe your online access query system for analysis of individual and/or group prescription drug claims data related to individual claimants, prescription drug information, network pharmacy information and prescriber information.  Offerors should describe all of the data available for analysis on this system. (NOTE: The highest scored Offeror's online access query system may be subject to demonstration prior to contract award.)"]
[{"$f":"+\"Q-\"&RIGHT(A50,1)+1","v":"Q-7"},"Confirm that your systems will report the MUSC Health Plan separately from the State Health Plan."]
[{"$f":"+\"Q-\"&RIGHT(A51,1)+1","v":"Q-8"},"The Contractor shall provide at PEBA’s request ad hoc or customized reports that cannot be generated from the online query system to analyze prescription drug claims and benefits in support of PEBA’s decision-making activities.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A52,1)+1","v":"Q-9"},"Describe typically requested ad hoc reports, including turnaround time and additional fees, if any."]
[{"$f":"+\"Q-\"&RIGHT(A53,1)+1","v":"Q-10"},"The Contractor shall be required by PEBA to provide assistance, as needed, with respect to the estimated cost impact of benefit modifications.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A54,2)+1","v":"Q-11"},"The Contractor shall provide to PEBA and/or its designated representative at least monthly and within ten (10) calendar days after the end of the reporting month a detailed provider listing file transmitted to PEBA or its designee in a secure manner. The file shall include at a minimum the information detailed in Attachment 9 - Detailed provider listing file to PEBA.","Select one"]
["Q-12","The Contractor shall provide to PEBA and/or its designated representative at least bi-weekly and within ten (10) calendar days after the end of the reporting period a detailed claims transaction file transmitted to PEBA or its designee in a secure manner. The file shall include at a minimum the information detailed in Attachment 10 - Detailed claims transaction file to PEBA.","Select one"]
["Q-13","In addition to the minimum claims detail, describe any other information that may be contained on the detailed claims transaction file provided to PEBA."]
["Q-14","The Contractor shall provide the performance guarantee reports that will confirm compliance or non-compliance with each of the proposed performance standards outlined below in Part 3.M.1, Performance Standards and Guarantees (Liquidated Damages). The reports shall be submitted to PEBA’s Procurement Officer within forty-five (45) days after the end of the quarter and plan year.","Select one"]
["Q-15","The Contractor shall provide to PEBA and/or its designated representative within sixty (60) calendar days after the end of each Plan quarter any reconciliation datasets it has created for the purpose of reconciling rebate payments with PEBA. The final reconciliation dataset used for the net PMPM cost must be received within one hundred-eighty (180) days after the end of the Plan year. The PBM’s internal reconciliation dataset shall contain at a minimum all fields used by the PBM for reconciliation purposes and must include both the NDC-11 code and claim ID as a logical link to the detailed claims transaction file as described in Part 3.F.7, Reporting. The detailed claims transaction file as described in Part 3.F.7, Reporting, shall be the system of record. Commercial Plan rebate payments should be delineated by SHP and MUSC Health Plan. The dataset for financial reconciliation purposes should include at a minimum the information detailed in Attachment 11 - Detailed financial reconciliation dataset.","Select one"]
["Q-16","The Contractor shall accept from PEBA a limited medical dataset no more frequently than monthly for the purpose of applying clinical rules the Contractor has in place and to assist in utilization management initiatives. The limited medical dataset will include the information detailed in Attachment 12 - Limited medical dataset to Contractor.","Select one"]
["Q-17","The Contractor shall accept from PEBA at least monthly an updated list of participating locally owned pharmacies and use this updated list to apply the correct MAC pricing for 30-day generic medications. The Contractor shall plan to meet with the appropriate PEBA staff no less frequently than semi-annually to review the list of participating locally owned pharmacies for reconciliation purposes.","Select one"]
["Q-18","The Contractor shall provide to PEBA’s third-party medical claims administrator, currently BlueCross BlueShield of South Carolina, at least bi-weekly and within ten (10) business days after the end of the reporting period a limited claims transaction file. The file should include at a minimum the following information detailed in Attachment 13 - Limited claims transaction file to PEBA’s third-party medical claims administrator.","Select one"]
["Q-19","The Contractor shall provide to PEBA and/or its designated representative at least quarterly and within ten (10) calendar days after the end of the reporting quarter a file listing all current Medicare Part B drugs as determined by CMS and transmitted to PEBA or its designee in a secure manner. The file shall include at a minimum the following information:","Select one"]
[null,"a.) NDC-11 code"]
[null,"b.) Drug name"]
[null,"c.) Medicare Part B drug indicator"]
[null,"d.) Medicare Part D drug indicator (for Part b drugs that can also be dispensed as a Part D drug as determined by the PBM based on CMS guidelines)."]
[{"$f":"+\"Q-\"&RIGHT(A63,2)+1","v":"Q-20"},"The Contractor shall cooperate with PEBA and PEBA’s evidence-based medicine contractor, currently Active Health Management (Active Health), and any successors, by making available both Plan eligibility and paid claims data to Active Health in mutually agreeable, secure, electronic formats. Data should be shared no less frequently than weekly. PEBA contracts with an evidence-based medicine contractor to apply evidence-based clinical rules to Members’ claims data with the purpose of communicating specific and timely treatment improvement recommendations to health care providers.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A68,2)+1","v":"Q-21"},"The Contractor must support key based SFTP for all data transfers, unless otherwise pre-approved by PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A69,2)+1","v":"Q-22"},"a.) Does your organization regularly omit the Social Security number from identification cards, benefit statements and benefit drafts?","Select one"]
[null,"b.) If yes, specify which documents do not include Social Security numbers."]
[null,"c.) If not, state why not and whether you have future plans to delete the Social Security number."]

{"sheet":"A-2g Service Questionnaire","index":9,"n_rows":60,"n_cols":3,"rows_kept":60,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2g: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["G.   INDIRECT EGWP with WRAP REQUIREMENTS"]
["PEBA requires the Contractor to provide and maintain a CMS approved prescription drug plan in the form of an Indirect EGWP with Wrap for Medicare eligible Members.  Please provide the information requested below and note that all pricing information must be provided in Tab A-10: Financial Proposal."]
["Q-1","The Contractor shall at a minimum provide all administrative services and clinical programs required by CMS and other federal entities. The Contractor shall utilize all cost-management tools permissible by and in accordance with CMS guidelines under the EGWP Plan.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-2"},"a.)  Are you able to duplicate the current pharmacy benefits for Medicare primary members covered by the SHP?","Select one"]
[null,"b.) If you are not able to duplicate the current pharmacy benefits, please describe the differences between the current pharmacy benefits for Medicare primary Members covered by the SHP and the plan you are able to provide."]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-3"},"Please describe your medication therapy management program, including the process for enrollment, targeting, intervention and outcomes reporting."]
[{"$f":"+\"Q-\"&RIGHT(A17,1)+1","v":"Q-4"},"Confirm that you will mirror the current clinical rules as closely as possible consistent with CMS regulations.","Select one"]
["Q-5","Please describe the participant out-of-pocket expense under an Indirect EGWP with Wrap plan for 90-day prescriptions filled at a retail pharmacy that is willing to accept home delivery pricing."]
["Q-6","Please provide a copy of your proposed MAC list for the EGWP in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and price per metric quantity.","Please label as \"Tab A-2g: MAC List - Indirect EGWP\"."]
["Q-7","Please provide a copy of your proposed Affiliated Pharmacy Specialty drug list for the EGWP in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and price per metric quantity. (Assume a dispense date of December 1, 2024 for the metric price per metric quantity.)","Please label as \"Tab A-2g: Affiliated Pharmacy Specialty Drug List - Indirect EGWP\"."]
["Q-8","Please provide a copy of your proposed Affiliated Pharmacy Specialty drug list for the EGWP in electronic format using MS Excel with read/write capabilities.  Include NDC-11 codes and price per metric quantity. (Assume a dispense date of December 1, 2024 for the metric price per metric quantity.)","Please label as \"Tab A-2g: Retail Specialty Drug List - Indirect EGWP\"."]
[{"$f":"+\"Q-\"&RIGHT(A22,1)+1","v":"Q-9"},"The Contractor shall establish and maintain a CMS-approved Medicare Part D formulary and P&T Committee support for the Medicare Part D formulary. The Contractor shall also establish and maintain a list of Wrap drugs and establish a process to automatically allow coverage of non-Medicare Part D drugs covered on the Wrap list in accordance with the Commercial Plan.","Select one"]
["Q-10","Will you provide all CMS required filings related to formulary, medication therapy management and other clinical programs on a timely basis?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A24,2)+1","v":"Q-11"},"Describe the transition process you will use for members who are currently using non-formulary prescription drugs, drugs requiring pre-authorization, step therapy and quantity level limits."]
[{"$f":"+\"Q-\"&RIGHT(A25,2)+1","v":"Q-12"},"The Contractor shall collect and pass through all federal subsidies including, but not limited to, the risk-adjusted direct per member per month subsidy, federal reinsurance payments for catastrophic coverage, Low Income Cost Sharing subsidies (LICS) and Low Income Premium Subsidies (LIPS) to the Plan in accordance with a published, agreed upon schedule. PEBA acknowledges and agrees the schedule may be subject to change, and the timing of payments is at the discretion of CMS, and payment delays on the part of CMS will result in payment delays to the Contractor and PEBA. In such cases, the Contractor will have no liability.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A26,2)+1","v":"Q-13"},"The Contractor will provide PEBA the CMS Monthly Membership Report (MMR) and Plan Payment Report (PPR) file as subsidy payments are pass throughs to PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A27,2)+1","v":"Q-14"},"a.) Please describe your preferred accounting methodology for tracking direct subsidy monies received as result of PEBA utilization to assure 100% pass through of costs and revenue."]
[null,"b.) Please describe your preferred accounting methodology for tracking  catastrophic reinsurance received as a result of PEBA utilization to assure 100% pass through of costs and revenue."]
[null,"c.) Please describe your preferred accounting methodology for tracking discounts received from pharmaceutical manufacturers for brand drugs in the Standard Part D benefit donut hole to assure 100% pass through of costs and revenue."]
[{"$f":"+\"Q-\"&RIGHT(A28,2)+1","v":"Q-15"},"The Contractor shall be responsible for the management of the low-income premium subsidy refunds to beneficiaries.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A31,2)+1","v":"Q-16"},"Confirm that you process low-income premium subsidy refunds to members and PEBA and low-income cost sharing refund requests to members.","Select one"]
["Q-17","The Contractor shall provide maintenance and support of the CMS Prescription Drug Event (PDE) process.","Select one"]
["Q-18","The Contractor shall provide PEBA with files in an agreed upon format containing the submitted Prescription Drug Event (PDE) data within five (5) business days of submission to CMS and subsequent PDE data associated with actual subsidies received.","Select one"]
["Q-19","Upon receipt of notification from CMS regarding a Member’s decision to opt out prior to their initial enrollment in EGWP or disenrollment during the Medicare open enrollment period, the Contractor shall notify PEBA of the action and send a letter informing the Member about their decision to opt out or disenroll from the Plan. A member may reenroll in EGWP at any time.","Select one"]
["Q-20","Describe the enrollment process, including when changes will be effective."]
["Q-21","Describe your standard disenrollment or opt out process, to include your flexibility to develop a modified process based on PEBA’s policy. Include when changes will be effective."]
["Q-22","The Contractor shall track Participant True-Out-of-Pocket expenses (TrOOP) in accordance with CMS requirements for the enhanced PDP, including delivery or required reporting and data feeds to communicate TrOOP balances to participants. The Contractor shall also track and supply a Participant’s Maximum-Out-of-Pocket (MOOP) to all drugs obtained by the member, included Part D and Wrap drugs.","Select one"]
["Q-23","Confirm that you will provide separate reporting and billing for the EGWP enrollees.","Select one"]
["Q-24","Please provide a distribution of employer clients by number of members in the following categories for who you provide EGWP administration services.  (Clients do not need to be identified.)"]
[null,"Less than 1,000 members"]
[null,"1,000 - 4,999 members"]
[null,"5,000 - 9,999 members"]
[null,"10,000 - 49,999 members"]
[null,"50,000 - 99,999 members"]
[null,"100,000 - 499,999 members"]
[null,"500,000 or more members"]
[{"$f":"+\"Q-\"&RIGHT(A40,2)+1","v":"Q-25"},"The Contractor shall provide a Medicare Prescription Payment Plan (M3P) in accordance with the minimum CMS regulations.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A48,2)+1","v":"Q-26"},"The Contractor shall cooperate with CMS audit requests in accordance with CMS regulations.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A49,2)+1","v":"Q-27"},"Will you provide all CMS required filings related to certification of compliance to waste, fraud and abuse requirements?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A50,2)+1","v":"Q-28"},"The Contractor shall provide customer service support including, but not limited to, open enrollment services for PEBA’s Medicare primary Members who are enrolled in the EGWP Plan. The customer service support should be provided by the same customer service representatives who support the non-Medicare primary Members.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A51,2)+1","v":"Q-29"},"a.) What is the location (city/state) of the customer service call center the Offeror will be utilizing for the EGWP? (Please note that this location cannot be offshore.)"]
[null,"b.) Is this the same facility that will be used for non-Medicare Members?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A52,2)+1","v":"Q-30"},"The Contractor shall produce and distribute Participant identification cards for those Members enrolled in the EGWP Plan. The card shall contain each Participant’s identification number in accordance with CMS guidelines and with final approval from PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A54,2)+1","v":"Q-31"},"The Contractor shall develop and implement in conjunction with PEBA and its designees, a comprehensive communication and Member education campaign to assure maximum participation in the EGWP Plan.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A55,2)+1","v":"Q-32"},"The Contractor shall develop CMS-required covered retiree communication templates, customer service scripting and other communication tools. The Contractor will be responsible for submission of the materials to CMS for review in accordance with applicable guidelines and waivers. The Contractor shall distribute such communications to eligible Members and shall also provide standard website development and maintenance consistent with CMS regulations.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A56,2)+1","v":"Q-33"},"Please provide a sample member communications package for the EGWP.","Please label as \"Tab A-2g: Indirect EGWP Sample Communications\"."]
[{"$f":"+\"Q-\"&RIGHT(A57,2)+1","v":"Q-34"},"What are your standards regarding turnaround time for issuing identification cards and accuracy?"]
[{"$f":"+\"Q-\"&RIGHT(A58,2)+1","v":"Q-35"},"a.) Does your member appeals process meet all CMS Medicare Part D requirements?","Select one"]
[null,"b.) Describe your member appeals process."]

{"sheet":"A-2h Service Questionnaire","index":10,"n_rows":40,"n_cols":3,"rows_kept":40,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2],[13,2,17,2],[23,2,26,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2h: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["H. RETIREE DRUG SUBSIDY (RDS) REQUIREMENTS"]
["Q-1","The Contractor shall provide monthly transmissions to CMS for purposes of collecting the Retiree Drug Subsidy. The Contractor shall participate in PEBA’s Medicare Qualified Retiree Prescription Drug Plan, and its activities will be consistent and comply with PEBA’s obligations as a Sponsor under 42 CFR Part 423.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"PEBA acknowledges it is required to apply for the Subsidy to CMS on an annual basis. The Contractor’s application assistance shall include at a minimum the following:","Select one"]
[null,"a.) Reviewing the Retiree Drug Subsidy Plan Sponsor application upon its release by CMS and providing guidance and responsibility determination between the Contractor and PEBA for its completion;"]
[null,"b.) Providing guidance and support to PEBA concerning appropriate language for use in the application;"]
[null,"c.) Providing the appropriate claims information or other information required by the application; and"]
[null,"d.) Providing a template work plan that will include installation and implementation guidelines."]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"CMS requires Plan sponsors to submit qualifying covered retiree eligibility updates monthly to keep an accurate account of subsidy-eligible Members. Upon PEBA’s request, the Contractor shall perform the following eligibility and CMS interface functions:"]
[null,"a.) The Contractor shall prepare the Medicare Part D Subsidy billing package that shall contain both summary and detailed per retiree information for the Medicare Part D Subsidy. The Contractor shall calculate the allowable gross costs and associated subsidy amount (net of any rebates and annual financial guarantees paid by the Contractor to PEBA) and provide the information to PEBA via CMS upload for approval and submission to CMS. In addition, the Contractor shall provide PEBA with a file in an agreed upon format containing the per Participant costs associated with each cost report.","Select one"]
[null,"b.) PEBA has entered into and uses a VDSA with CMS. The Contractor shall offer PEBA the option of a monthly, quarterly or interim annual billing cycle (assuming CMS continues to allow these options). PEBA shall advise the Contractor at the time of the application if it wishes to receive payments from CMS on a monthly, quarterly or interim annual basis so the Contractor can prepare submissions accordingly. The monthly and quarterly options shall utilize estimated rebates to calculate the subsidy amount. As estimated rebates shall be utilized for monthly, quarterly and interim annual subsidy filings, the Contractor shall calculate a rebate and annual guarantees deemed to be price concession “true up” to adjust the subsidy billing according to actual rebates as required by CMS no later than fifteen (15) months after the end of the Plan year. If PEBA wishes to challenge specific CMS eligibility or payment determinations, it shall be responsible for filing an appeal with CMS.","Select one"]
[null,"c.) PEBA shall provide complete and accurate eligibility information including qualifying covered retiree eligibility, the subsidy eligibility period applicable to those retirees and CMS verifications to the Contractor. PEBA shall be solely responsible for actual approval and final submission of cost report data uploaded by the Contractor to CMS via the CMS Retiree Drug Subsidy (RDS) website. The Contractor shall work with PEBA to process CMS formatted covered retiree list file during the final reconciliation process for the plan year.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A19,1)+1","v":"Q-4"},"The Contractor shall produce and distribute via regular mail Notice of Creditable Coverage letters upon release of CMS guidance. The Contractor shall provide PEBA with sample of the letter for PEBA approval prior to distribution.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A23,1)+1","v":"Q-5"},"The Contractor shall provide PEBA with sample communication language to use with Medicare-eligible populations. The Contractor shall provide template communication language for the following communication materials:","Select one"]
[null,"a.) Newsletter articles;"]
[null,"b.) Frequently Asked Questions (FAQs) and their corresponding responses to be used in communications or CSR training; and"]
[null,"c.) Medicare Part D specific content for benefit materials, “Welcome Kits”, and Open Enrollment campaigns."]
[{"$f":"+\"Q-\"&RIGHT(A24,1)+1","v":"Q-6"},"In compliance with CMS and False Claims Act requirements, the Contractor shall store all PEBA’s claims, utilization management and eligibility data for a ten (10) year period.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A28,1)+1","v":"Q-7"},"To the extent requested by PEBA, the Contractor shall submit to the True Out-of-Pocket (TrOOP) facilitator, TrOOP costs for the secondary claims of PEBA’s participants enrolled in Medicare Part D.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A29,1)+1","v":"Q-8"},"The Contractor and PEBA shall abide by all applicable federal and state laws and regulations, as well as CMS guidance related to the Retiree Drug Subsidy Program.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A30,1)+1","v":"Q-9"},"To the extent applicable to the Retiree Drug Subsidy Program, the Contractor shall make its books and other records available to the Department of Health and Human Services and the Office of Inspector General, or their authorized designees, for audits, evaluations and inspections. PEBA, and to the extent applicable the Contractor, shall maintain the following records for ten (10) years after the expiration of the plan year in which the costs were incurred or longer in the event of (or if PEBA should know that the records are subject to) an ongoing investigation, litigation or negotiation involving civil, administrative or criminal liability: reports and working documents of the actuaries who wrote the attestation submitted in accordance with 42 CFR § 423.884(a); all documentation of costs incurred and other relevant information utilized for calculating the amount of the subsidy payment including the underlying claims data; and any other records specified in applicable CMS guidance.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A31,1)+1","v":"Q-10"},"The Contractor shall cooperate and provide PEBA information and guidance regarding the Retiree Drug Subsidy Program.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A32,2)+1","v":"Q-11"},"The Contractor shall provide CMS with the eligibility file with the qualifying covered retirees. The Contractor shall collect from CMS and remit to PEBA the verifications of eligibility by CMS for the qualifying covered retirees. The Contractor shall provide PEBA with periodic updates to the qualifying covered retiree eligibility file. PEBA is responsible for claims of Eligible Persons, even if it is later determined that such claims are not eligible for the retiree drug subsidy. PEBA reserves the right to determine for which enrollee populations PEBA will apply for the subsidy. PEBA shall elect for the Contractor to submit the updates to CMS on a monthly or quarterly basis, consistent with applicable CMS directives.","Select one"]
["Q-12","The Contractor upon approval of PEBA shall submit to CMS the initial qualifying covered retiree eligibility file for calendar year 2026 and all necessary information. PEBA acknowledges that for subsequent contract years, submission may be due to CMS at least ninety (90) days before the start of the plan year.","Select one"]
["Q-13","The Contractor will provide PEBA no less than 10 business days to review and approve the initial Qualifying Covered Retiree eligibility file prior to the Contractor submitting to CMS.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A35,2)+1","v":"Q-14"},"PEBA acknowledges deviation from the requirements in this Section and CMS requirements might result in noncompliance that will affect PEBA’s eligibility for the subsidy.","Select one"]
["Q-15","PEBA shall not delegate to the Contractor the responsibility for filing an actuarial equivalence attestation with CMS in accordance with CMS directives. PEBA acknowledges CMS has required the actuarial attestation to be submitted to CMS on the date PEBA’s subsidy application is filed with CMS.","Select one"]
["Q-16","PEBA shall reasonably cooperate with the Contractor in providing any information required to be submitted to CMS or necessary for any submission to CMS. PEBA acknowledges information provided to the Contractor in connection with the Retiree Drug Subsidy Program might affect the calculation of CMS payments to PEBA and that inaccuracies to CMS in such information might result in federal civil action and/or criminal prosecution. PEBA agrees that all the information it shall submit to the Contractor in connection with the Retiree Drug Subsidy Program shall be accurate, complete and truthful.","Select one"]
["Q-17","Describe, in detail, your approach to providing RDS services to PEBA."]
["Q-18","Describe your background and experience in providing RDS services."]

{"sheet":"A-2i Service Questionnaire","index":11,"n_rows":44,"n_cols":3,"rows_kept":44,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2i: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["I. FINANCIAl REQUIREMENTS"]
["Q-1","Fixed administrative fess payable to the Contractor:"]
[null,"a.) Administrative fees are specific to PEBA. The administrative fees must be quoted on a fully loaded basis (i.e., fees must include all direct and indirect costs, general and administrative overhead, purchasing burden, underwriting, actuarial related services, subcontracting and profit). All administrative fees must be quoted on per member per month (PMPM) basis. Three (3) administrative fees must be quoted: (a) a fixed, single, all-inclusive PMPM administrative fee for the Commercial Plan Participants; (b) a fixed, single, all-inclusive PMPM administrative fee for EGWP Plan Participants; and (c) a fixed, single, all-inclusive PMPM administrative fee for the Contractor’s Medicare Part B coordination of benefits solution. No other fees or charges may be added to the Contract after award, nor will the Contractor be compensated on any basis other than the applicable fully loaded PMPM rate.","Select one"]
[null,"b.) The administrative fee(s) payable to the Contractor shall be considered full and complete compensation for all goods, services and requirements to provide pharmacy benefits to PEBA.","Select one"]
[null,"c.) All disbursements of administrative fees shall be processed via Automated Clearing House (ACH) transaction to the financial institution provided by the Contractor. The ACH transaction will be initiated by the South Carolina State Treasurer.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"Commercial Plan Participants fixed administrative fee:"]
[null,"a.) The total dollar amount of monthly administrative fees for the Commercial Plan Participants shall be determined by PEBA based upon PEBA enrollment files.","Select one"]
[null,"b.) The Commercial Plan administrative fee shall be remitted to the Contractor monthly by the 15th working day of the current month per the state’s working schedule.","Select one"]
[null,"c.) The Contractor shall not provide invoices for the Commercial administrative fee to PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A17,1)+1","v":"Q-3"},"EGWP Plan Participants fixed administrative fee:"]
[null,"a.) The total EGWP monthly administrative fee shall be determined by the Contractor based upon the Contractor enrollment files and the contracted fixed single, all-inclusive PMPM administrative fee for the EGWP Participants."]
[null,"b.) The Contractor shall separately bill no more than monthly, aligned with the billing of the claims and provide invoices to clearly identify the enrollment number and the fixed fee agreeing to the total invoiced."]
[{"$f":"+\"Q-\"&RIGHT(A21,1)+1","v":"Q-4"},"Medicare Part B coordination of benefits solution administrative fee:"]
[null,"a.) The total monthly Medicare Part B coordination of benefits solution administrative fee shall be determined by the Contractor based upon the Contractor enrollment files for EGWP Participants and for Medicare primary members who opt out of the EGWP Plan and enroll in the Commercial Plan and the contracted fixed single, all inclusive, PMPM administrative fee for these Participants."]
[null,"b.) The Contractor shall separately bill no more than monthly, aligned with the billing of the claims and provide invoices to clearly identify the enrollment number and the fixed fee agreeing to the total invoiced."]
[{"$f":"+\"Q-\"&RIGHT(A24,1)+1","v":"Q-5"},"Claims reimbursements to the Contractor:"]
[null,"a.) The Contractor shall accept claims reimbursements either bi-weekly or semi-monthly.","Select one"]
[null,"b.) The Contractor shall provide invoices to PEBA, preferably via secured web-based access. Invoices must clearly identify the claims period and provide itemization of amounts of claims, credits, refunds and offsets by plan for all plans offered by PEBA (currently Standard, Savings and MUSC). The Contractor shall record and collect overpayments in a timely manner and offset claims invoices for refunds. The layout of the invoices must be in an acceptable format approved by PEBA.","Select one"]
[null,"c.) The Contractor shall provide a monthly itemized reconciliation of PEBA account activity to claims payment reimbursement, including itemized provider reimbursements, outstanding payments, refunds and other offsets.","Select one"]
[null,"d.) PEBA shall remit reimbursement to the Contractor within five business days following receipt of invoices. The Contractor shall not hold PEBA funds, such that interest accrues to the Contractor’s benefit. All claims reimbursements shall be processed via Automated Clearing House (ACH) transaction to the financial institution provided by the Contractor. The ACH transaction will be initiated by the South Carolina State Treasurer.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A27,1)+1","v":"Q-6"},"Pharmacy rebates due to PEBA:"]
[null,"a.) Rebates shall provide complete pass through of all revenue the Contractor receives from outside sources related to PEBA’s utilization or enrollment of programs, which includes, but is not limited to, manufacturer payments, rebates, fees, discounts, grants or payments of any kind associated with the utilization of the PEBA pharmacy benefit program.","Select one"]
[null,"b.) The Contractor shall remit quarterly pharmaceutical rebates to PEBA to be paid sixty (60) days after the end of each quarter for the preceding quarter. Quarterly rebates shall include the entirety of pharmaceutical rebates earned and paid the previous quarter. Rebates accrued and received by the Contractor or its subcontractor, for PEBA utilization not yet paid to PEBA in previous quarterly payments shall be remitted along with the next scheduled quarterly rebate payment. The Contractor shall provide reports for all rebates remitted to identify the basis of the rebates received. Rebates payments should be forwarded to PEBA via ACH/wire to the financial institution provided by PEBA to the Contractor.","Select one"]
[null,"c.) The Contractor shall provide PEBA with projected rebate totals for each plan year prior to the beginning of each plan year and provide updates to the estimated plan year rebates no more than every 90 days.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A32,1)+1","v":"Q-7"},"Pharmacy net PMPM cost guarantees due to PEBA:"]
[null,"a.) The Contractor shall remit any amounts due that are related to the net PMPM cost guarantees to PEBA no later than 180 days following the end of the reporting plan year.","Select one"]
[null,"b.) The Contractor shall provide reporting demonstrating guarantee outcomes to PEBA no later than 180 days following the end of the reporting plan year. Reporting should demonstrate guarantee outcomes for both the Commercial and EGWP plans.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A36,1)+1","v":"Q-8"},"CMS subsidies due to PEBA:"]
[null,"a.) The Contractor shall remit all available EGWP subsidy dollars promptly to PEBA. The Contractor shall coordinate with CMS to acquire all subsidy funds available to PEBA. The Contractor shall remit subsidy funds to PEBA within 30 days of receipt. The Contractor shall not hold PEBA funds, such that interest accrues to the Contractor’s benefit. All subsidies remitted should be forwarded to PEBA via ACH/wire to the financial institution provided by PEBA to the Contractor. The Contractor shall provide reports that validate any subsidies remitted to PEBA.","Select one"]
[null,"b.) The Contractor shall provide PEBA with projected subsidy totals for each plan year no more than 30 days prior to the beginning of each plan year and provide updates to the estimated plan year subsidies no more than every 90 days.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A39,1)+1","v":"Q-9"},"The Contractor shall provide documentation to support all payments to PEBA to include, but not limited to, how the payment was derived and when the contractor received the payment. ","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A42,1)+1","v":"Q-10"},"The Contractor shall provide to PEBA a SOC1 Type 2 report by August 15 each year. Contractor shall provide additional financial data as requested.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A43,2)+1","v":"Q-11"},"Describe, in detail, your process of releasing pharmacy payments, including the timeline between requesting claims reimbursement from PEBA and releasing payment to pharmacies."]

{"sheet":"A-2j Service Questionnaire","index":12,"n_rows":47,"n_cols":3,"rows_kept":47,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2j: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["J. ELIGIBILITY OF MEMBERS AND COMPUTER SUPPORT REQUIREMENTS"]
["Q-1","PEBA shall provide the Contractor an initial electronic membership file containing only current Subscribers and their dependents for purposes of establishing eligibility. The Contractor will be provided one file feed using the 834 EDI layout that will contain both Commercial and EGWP plans membership. PEBA can provide codes to identify and split the records into Commercial and EGWP plans membership or the Contractor can determine if a Subscriber and/or their dependent should be enrolled in the Commercial or EGWP plan based on the information provided on the membership file such as Subscriber type (e.g., active/non-active) and Medicare status.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"PEBA shall provide the Contractor a daily electronic file of updates or changes including new enrollments, changes in a Member’s enrollment, reinstatement of a Member’s enrollment and termination of a Member’s enrollment for purposes of verifying eligibility at the point of sale prior to dispensing an eligible Member’s prescription. The Contractor shall accept, process, maintain and update eligibility information from the files provided by PEBA within 48 hours of receipt. The Contractor shall refer to PEBA for consideration and PEBA’s final decision any questions with respect to an individual’s eligibility for benefits.","Select one"]
["Q-3","PEBA conforms to the Commercial X12 834 data transmission through electronic data interchange. The Contractor must support key based SFTP data transfers, unless otherwise pre-approved by PEBA.","Select one"]
["Q-4","The Contractor must support forced TLS for all email communications with PEBA.","Select one"]
["Q-5","The Contractor shall provide PEBA with a daily file acknowledgement of files received and entered in the Contractor’s system.","Select one"]
["Q-6","The Contractor shall maintain in its database occurrences of Member coverage history, as well as Member opt out history (including effective dates, termination dates and enrolling in another Medicare Part D prescription drug plan) sufficient to adjudicate claims, reconcile subsidy information and reconcile eligibility data with PEBA. PEBA staff shall be able to access Member history in the Contractor’s system.","Select one"]
["Q-7","The Contractor shall provide PEBA with a monthly membership file containing only Covered Members in an active status, for comparison to PEBA’s database. PEBA will accept the file in an electronic format acceptable to PEBA and PEBA’s eligibility database shall be considered the system of record for any questions pertaining to eligibility of benefits.","Select one"]
["Q-8","The Contractor shall provide PEBA with a weekly PDP report. The report should include all transactions approved by CMS including, enrollments, disenrollments, deaths, as well as subscribers and dependents who enrolled or disenrolled in another Medicare Part D prescription plan.","Select one"]
["Q-9","The Contractor shall provide a secure online connection for purposes of permitting selected PEBA personnel access to make online inquiries of the Contractor’s database and the ability to make real-time changes to the Contractor’s records regarding a participant’s eligibility. The Contractor shall provide different levels of access to the database for employees based on PEBA’s specifications. Regardless of the level of access, the data for all State Health Plan and MUSC Health Plan members shall be accessible to the employee through a single sign-on. All changes by PEBA are subject to strict controls including a limited number of persons with access; use of passwords. The Contractor shall provide PEBA documentation of all direct updates by PEBA to the Contractor’s database. Data integrity, security requirements, and HIPAA regulations require an encrypted connection for transfer of data. Secure online connections must support the most current best practice version of TLS for encryption, unless otherwise pre-approved by PEBA. Connections other than web connections must use other best practice encryption, such as VPN, as approved by PEBA.","Select one"]
["Q-10","The PEBA would like direct access to the Offeror's eligibility systems for review and input purposes.  Please describe your ability to provide PEBA with direct access to the eligibility system only."]
[{"$f":"+\"Q-\"&RIGHT(A22,2)+1","v":"Q-11"},"Offerors should state that it understands and agrees that it shall provide a secure online connection for purposes of permitting selected PEBA personnel access to make online inquiries of the Offeror's database and the ability to make limited routine changes to the Offeror's records regarding covered person eligibility."]
[{"$f":"+\"Q-\"&RIGHT(A23,2)+1","v":"Q-12"},"Describe, in detail, all the information you will provide in your online inquiry and entry program."]
[{"$f":"+\"Q-\"&RIGHT(A24,2)+1","v":"Q-13"},"Please describe your eligibility system that will be used to keep track of the PEBA's eligibility files, including:"]
[null,"w System \"trade name\""]
[null,"w System organization"]
[null,"w Date eligibility system was put in place"]
[null,"w Number of system upgrades since inception"]
[{"$f":"+\"Q-\"&RIGHT(A25,2)+1","v":"Q-14"},"a.) Is eligibility processing real-time with the claim system?","Select one"]
[null,"b.) If no, what is the delay time?","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A30,2)+1","v":"Q-15"},"a.) Offerors should state that it understands and agrees that it will be responsible for all costs associated with the installation, line test, and maintenance of the data line equipment.  "]
[null,"b.) Offerors should provide the name, background and qualifications of the individual who will be the contact for  PEBA's use in resolving any computer related problems."]
[{"$f":"+\"Q-\"&RIGHT(A32,2)+1","v":"Q-16"},"Describe, in detail, the training you will provide to the PEBA staff on all of your customer service systems at the PEBA 's office in Columbia, South Carolina."]
[{"$f":"+\"Q-\"&RIGHT(A34,2)+1","v":"Q-17"},"The Contractor shall implement and document comprehensive security programs securing all data, informational and transactional components from unauthorized access from any internal or external source including Contractor and its subcontractors, PEBA employees, third party users or outside intruders. Contractor shall use, implement and document reasonable, recognized and proven appropriate security practices to make information secure. The security system must include the capability of immediate detection and documentation of any security compromise or breach. If the security of the system is compromised or breached in any way, the Contractor shall notify PEBA promptly, but not to exceed two business days following the compromise or breach. The notice shall be in writing, delivered by means establishing actual receipt (e.g., in hand, email with return receipt, etc.) to the PEBA Privacy Officer and shall include the time, nature, diagnosis (including cause), actual and potential consequences, and recommendations for corrective action of the breach or compromise. If emergency situations preclude written notice within two business days, notice may be given to the PEBA Privacy Officer by other than in writing. Written notice as required under this paragraph shall then be provided as soon as practicable under the circumstances, as agreed to by the PEBA Privacy Officer. The Contractor shall be liable to PEBA for any compromise or breach whatsoever and shall be liable for all reasonable and appropriate costs (as determined by PEBA) associated with the compromise or breach. Offerors shall fully describe the methods and means to be deployed to satisfy this requirement (Q-26 of Technical Proposal, Tab A-2j: Service Description Questionnaire). These requirements apply to all activities to be performed hereunder including, but not limited to, those set out in Part 3.E.8 above.","Select one"]
["Q-18","To comply with confidentiality policies and applicable laws, the Contractor shall ensure it has the ability to restrict certain subscribers from accessing contact or claim information for dependents with such an indicator on their profile. In addition, the Contractor will ensure any mailings or communications for restricted dependents are sent to the separate address provided by PEBA. The Contractor will also ensure a separate authorized representative be documented on restricted dependent profiles and provide authorized representatives with the necessary access to handle the affairs of restricted dependents.","Select one"]
["Q-19","The Contractor shall maintain encrypted database backups with such redundancy and in a manner that will eliminate disruption of service or loss of data due to system or program failures.","Select one"]
["Q-20","The Contractor shall maintain a disaster preparedness plan that will limit service interruption in case of emergency (force majeure) and will ensure compliance with all requirements under the Contract. At a minimum, the Contractor shall have at least one remote back up and disaster recovery site capable of fully (100%) restoring its processing capability within seventy-two (72) hours and all data must be captured and backed up on a continuous basis up to any service interruption. The disaster recovery plan shall include instantaneous failover and recovery without loss of data, information or transactions. The plan must include a disaster recovery site(s) located outside the effects of a common disaster that would otherwise impact the primary site.","Select one"]
["Q-21","The Contractor shall maintain a business continuity plan including provisions for the periodic testing of system failover, disaster recovery and redundant communication cutover.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A39,2)+1","v":"Q-22"},"Describe, in detail, how you will maintain database backups in a manner that will eliminate disruption of service or loss of data due to system or program failures."]
["Q-23","a.) Describe your disaster preparedness and recovery plans."]
[null,"b.) Offerors should state the maximum period of interruption in the case of an emergency."]
[{"$f":"+\"Q-\"&RIGHT(A41,2)+1","v":"Q-24"},"Offerors shall fully describe the methods and means to be deployed in order to satisfy the requirement described in Part 3 J.10 of the RFP.","Please label as \"Tab A-2j: Data Security\"."]
[{"$f":"+\"Q-\"&RIGHT(A43,2)+1","v":"Q-25"},"Offerors shall fully complete the Service Provider Security Assessment Questionnaire included in Attachment Three (3) of Part 8 of the RFP.","Please label as \"Tab A-2j: Service Provider Security Questionnaire\"."]
[{"$f":"+\"Q-\"&RIGHT(A44,2)+1","v":"Q-26"},"Please state if you provide a test environment (file)."]
[{"$f":"+\"Q-\"&RIGHT(A45,2)+1","v":"Q-27"},"Briefly describe how your organization will process the HIPAA 834 file layout internally (convert to proprietary file specification, dump to paper, etc.)"]
[{"$f":"+\"Q-\"&RIGHT(A46,2)+1","v":"Q-28"},"What practices and policies have you implemented to ensure the confidentiality of all confidential information, including protected health information as defined by the HIPAA privacy rule, retiree/member information, or other sensitive information of PEBA and its retirees and/or members?"]

{"sheet":"A-2k Service Questionnaire","index":13,"n_rows":39,"n_cols":3,"rows_kept":39,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2],[14,2,23,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2k: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["K. IMPLEMENTATION PROGRAM (Not an evaluated item)"]
["Q-1","The Contractor shall prepare and execute a Final Implementation Plan. The Final Implementation Plan shall be based upon the proposed implementation plan and coordinated through and developed in conjunction with PEBA. The Contractor’s Final Implementation Plan shall outline, in detail, all the steps necessary to begin full performance of the contract on January 1, 2026. The Final Implementation Plan shall specify expected dates of completion of all necessary tasks, how the tasks will be accomplished, the identity the person(s) responsible for each task and the personnel who might be onsite during the implementation process.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"The Contractor shall submit the Final Implementation Plan to PEBA’s Procurement Officer for review and approval no later than thirty (30) calendar days following the final award. Implementation activities shall not commence prior to PEBA’s approval of the Final Implementation Plan.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"The Contractor shall include the specific tasks and completion dates below in their proposed implementation plan:","Select one"]
[null,"a.) Review content for the Insurance Benefits Guide (June 2025)"]
[null,"b.) Open enrollment materials (August 31, 2025)"]
[null,"c.) Review content for the Benefits Administrator Manual (October 2025)"]
[null,"d.) Letters notifying all current Members about the transition to a new Pharmacy Benefits Manager (November 1, 2025)"]
[null,"e.) Welcome kit, including identification cards, to be used for new members beginning January 1, 2026 (December 1, 2025)"]
[null,"f.) Forms to be used beginning January 1, 2026 (December 1, 2025)"]
[null,"g.) Letters, including appeal decision letters, to be used beginning January 1, 2026 (December 1, 2025)"]
[null,"h.) Onsite training for PEBA’s customer service staff (December 1, 2025)"]
[null,"i.) Mailing of new identification cards to current members (December 15, 2025)"]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-4"},"Upon request of PEBA, the Contractor shall accept from the incumbent Pharmacy Benefits Manager, a claims file that shall be used to transfer Participants’ current prior authorization and coverage review status, specialty pharmacy prescriptions and home delivery prescriptions. The Contractor shall document the process for receiving a claims file to ensure each Participant’s current status is transferred. The Contractor shall notify Participants at least 60 days in advance of implementation of any drug tier changes, formulary exclusions or other changes that might impact a Participant’s coverage beginning January 1, 2026.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A25,1)+1","v":"Q-5"},"The Contractor shall pay PEBA $5,000 per day for each day or partial day in the event of any failure by the Contractor to strictly adhere to the Final Implementation Plan as agreed upon between the Contractor and PEBA (and without the express written waiver of PEBA before the date of the agreed upon time for completion). If, after fifteen (15) days’ notice, the Contractor has failed to pay any amount due hereunder, the amount shall be withdrawn from the security (See Part 7.59 Security for Performance, Damages).","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A26,1)+1","v":"Q-6"},"The Contractor shall complete no later than November 30, 2025, a live test demonstration of the processing of test claim scenarios with 100% accuracy. The claim scenarios (approximately 30 scenarios) shall be provided by PEBA to the Contractor with sufficient detail to support the adjudication process. Production PEBA enrollment will be used for member data and the Contractor shall assume its contracted pharmacy networks (retail and retail maintenance). The demonstration must be performed in the presence of PEBA staff and/or designated representatives or using a mutually agreed upon electronic presentation methodology.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A27,1)+1","v":"Q-7"},"PEBA may request the Contractor provide PEBA a dedicated manager onsite at PEBA 30 days prior to implementation and up to 90 days following implementation.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A28,1)+1","v":"Q-8"},"Please discuss your procedures and processes for handling the following during the transition period:"]
[null,"• Transfer of Members' current prior authorization and coverage review status, specialty pharmacy prescriptions, home delivery prescriptions and other transitions of care."]
[null,"• Employee communications regarding change in administrators."]
[{"$f":"+\"Q-\"&RIGHT(A29,1)+1","v":"Q-9"},"Implementation Plan"]
[null,"a.) Name of the person with overall responsibility for planning, supervising and implementing the program for PEBA."]
[null,"b.) Title"]
[null,"c.) What other duties, if any, will this person have during implementation?  Please include the number and size of other accounts for which this person will be responsible during the same time period."]
[null,"d.) What percentage of this person's time will be devoted to PEBA during the implementation process?"]
[null,"e.) Please provide an organizational chart identifying the names, area of expertise, functions, and reporting relationships of key people directly responsible for implementing PEBA's account.   In addition, resumes of these individuals should be included.","Please label as \"Tab A-2k: Implementation Team Organizational Chart\"."]
[null,"f.) Provide a detailed implementation plan that clearly demonstrates the Offeror's ability to meet PEBA's requirements to have a fully functioning program in place and operable on January 1, 2026.  This implementation plan should include a list of specific implementation tasks/transition protocols and a time-table for initiation and completion of such tasks, beginning with the contract award and continuing through the effective date of operation (January 1, 2026).  The implementation plan should be specific about requirements for information transfer as well as any services or assistance required from PEBA during implementation. The implementation plan should also include tasks and schedules specific to communications and training as outlined, but not limited to those described in this RFP Section K.3","Please label as \"Tab A-2k: Implementation Plan\"."]
[{"$f":"+\"Q-\"&RIGHT(A32,1)+1","v":"Q-10"},"Describe the process you propose to provide a January 1, 2026, transition that is as seamless as possible for all Members."]

{"sheet":"A-2l Service Questionnaire","index":14,"n_rows":30,"n_cols":3,"rows_kept":30,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2],[25,2,29,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2l: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["L.  ACCOUNT MANAGEMENT AND PERSONNEL REQUIREMENTS"]
["Q-1","The Contractor must provide an Account Management Team that shall include at a minimum a designated account manager, a designated financial analyst, a dedicated operations (claims and customer service) manager, a designated registered pharmacist (clinical account manager) and a designated pricing guarantee and rebate payment reconciliation analyst. These five (5) distinct account personnel shall be knowledgeable about all aspects of the Pharmacy Benefits Management Program and shall be onsite during the implementation process until PEBA is satisfied all transitional issues have been resolved. PEBA reserves the right to recall the vendor onsite in the event of ongoing problems. The account manager shall serve as the primary contact to respond to PEBA’s needs, questions and/or issues. The operations manager shall serve as primary contact for customer inquiries from PEBA Customer Service. In addition to the five account personnel, the Contractor must provide a designated resource specializing in policies and procedures related to EGWP and RDS, as well as a designated marketing/communications account personnel as defined in Part 3.E, Communications and Training, for a total of seven account personnel.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"Provide the key personnel designated in its proposal. No diversion to key personnel of the Account Management Team should be made by the Contractor during the first year of the Contract. After the first year, no diversion to key personnel shall be made without notification to PEBA. The Contractor shall provide PEBA with immediate notice of the termination or transfer of any key personnel, the reason(s) for the termination or transfer, and an action plan for replacing the terminated or transferred employee. Key personnel should be replaced with personnel of substantially equal ability, knowledge and qualifications.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A14,1)+1","v":"Q-3"},"Describe the organization and structure of the account service team that will support PEBA. Include the rationale for this structure and the ways in which it is particularly responsive to PEBA's needs and goals."]
[{"$f":"+\"Q-\"&RIGHT(A15,1)+1","v":"Q-4"},"The Contractor must provide a designated Executive Sponsor for PEBA that has the authority to make binding decisions on behalf of PEBA’s account with the Contractor. ","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A16,1)+1","v":"Q-5"},"Name of the person with overall responsibility for planning, supervising and performing account services for PEBA:"]
[null," • Title"]
[null," • Where will the account manager be located?"]
[null," • What other duties, if any, does this person have?  Please include the number and size of other accounts for which this person is responsible."]
[null," • What percentage of this person's time will be devoted to the PEBA?"]
[null," • Please provide an organizational chart identifying the names, functions and reporting relationships of key people directly responsible for account support services to PEBA.  It should also document how many account executives and group services representatives will work full-time on PEBA's account and how many will work part-time on PEBA's account.  ","Please label as \"Tab A-2l: Account Management Team Organizational Chart\"."]
[null," • Describe account management support, including the mechanisms and processes in place to allow PEBA personnel to communicate with account service representatives, hours of operation; types of inquiries that can be handled by account service representatives; and a brief explanation of information available on-line.  PEBA requires identification of an account services manager to respond to inquiries and problems, and a description of how the Offeror's customer service and other support staff will respond to subscriber or client inquiries and problems.  ","Please label as \"Tab A-2l: Account Management Support\"."]
[{"$f":"+\"Q-\"&RIGHT(A17,1)+1","v":"Q-6"},"Please provide a bio of each team member, including length of time with your organization and job held while with your organization.","Please label as \"Tab A-2l: Account Team Biographies\"."]
[{"$f":"+\"Q-\"&RIGHT(A24,1)+1","v":"Q-7"},"Will this team be responsible for implementing the PEBA account?"]
[{"$f":"+\"Q-\"&RIGHT(A25,1)+1","v":"Q-8"},"The Contractor’s account management team shall meet with PEBA as necessary, but not less than quarterly, to review financial performance and service issues and to take corrective action as directed and approved by PEBA. Both the pricing guarantee and rebate payment reconciliation analyst and the EGWP/RDS specialist should attend meetings as requested by the PEBA team managing these initiatives. One of the scheduled meetings shall consist of an annual review at PEBA’s office in Columbia, SC to review and summarize financial and clinical issues regarding the claims experience and financial performance of the Pharmacy Benefit Management program during the previous plan year. The Contractor shall also during these meetings assist PEBA in its ongoing review of the Prescription Drug Program, and advise PEBA to the following:","Select one"]
[null,"a.) Follow-up to and status of any agreed upon corrective action resulting from any preceding meetings."]
[null,"b.) Developments in the pharmacy benefit management industry as a whole including, but not limited to, new programs, techniques, models and the like that will reduce PEBA’s cost while improving upon the Member’s health and satisfaction of the benefit."]
[null,"c.) Legal developments including, but not limited to, regulatory, administrative, statutory and judicial developments relating to pharmacy benefit management. However, the Contractor must promptly notify PEBA throughout the year of any changes in the law or regulations affecting pharmacy benefit management activities."]
[null,"d.) Contractor must be familiar with and fully comply with all PBM Statutes in the South Carolina Code of Laws."]

{"sheet":"A-2m Service Questionnaire","index":15,"n_rows":37,"n_cols":3,"rows_kept":37,"cut":false,"hidden":true,"merged":[[8,0,8,2],[10,0,10,1],[7,0,7,2]],"read":"row_number_cap"}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2m: Service Description Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["The EGWP Plan will provide pharmacy benefits for all Medicare primary members covered by the State Health Plan.\n\nThe Commercial Plan will provide pharmacy coverage for all non-Medicare members in the State Health Plan, MUSC Health Plan, and all Medicare Primary members who have opted out of the EGWP Plan."]
["Instructions:  Please provide a response to each of the following questions.  If a drop down list is available, please select a response from that list.  If your response for a question exceeds 1,024 characters in length, complete your response in \"Tab A-2n: Questionnaire Answers\" using the directions provided in Tab A-2n."]
[]
["Question",null,"Response"]
["M.  PERFORMANCE STANDARDS AND GUARANTEES (LIQUIDATED DAMAGES)"]
["Q-1","Performance shall be provided in a first-class manner. The Contractor shall be responsible to PEBA and liable for any delay, breach, or non-performance of any portion of the Contract including, but not limited to, overpayment, underpayment, or nonpayment. The Contractor’s proposed performance standards and guarantees shall be specific to PEBA and shall not be measured by an aggregate of Contractor’s overall book of business, unless otherwise specified. Additionally, the Contractor’s proposed performance standards and guarantees shall be measured and assessed during the same period. Multiple periods may not be aggregated to make up for one or more failed periods. The Contractor shall strictly adhere to their proposed performance standards and guarantees for deviation from those standards EXCEPT as agreed to between PEBA and the Contractor. The Contractor shall propose at a minimum, the following performance standards/measurements as defined in Tab A-9."]
[null,"a.) Average speed to answer ","Select one"]
[null,"b.) Call abandonment rate","Select one"]
[null,"c.) Paper claims processing time","Select one"]
[null,"d.) Automated claim system availability rate","Select one"]
[null,"e.) Home delivery dispensing accuracy rate","Select one"]
[null,"f.) Financial accuracy rate","Select one"]
[null,"g.) Home delivery dispensing turnaround time","Select one"]
[null,"h.) Eligibility transaction processing time","Select one"]
[null,"i.) Timeliness of mailing ID Cards for EGWP Members","Select one"]
[null,"j.) Timeliness of standard reporting package ","Select one"]
[null,"k.) Member access rate to a network of participating retail pharmacies","Select one"]
[null,"l.) Decrease in size of participating retail pharmacy network","Select one"]
[null,"m.) EGWP subsidies (timeliness and accuracy)","Select one"]
[null,"n.) RDS final reconciliation (timeliness and accuracy)","Select one"]
[null,"o.) RDS monthly cost reports (timeliness and accuracy)","Select one"]
[null,"p.) Timeliness of Notices of Creditable and Non-Creditable Coverage","Select one"]
[]
[{"$f":"+\"Q-\"&RIGHT(A13,1)+1","v":"Q-2"},"After-call satisfaction survey results shall be submitted to PEBA within forty-five (45) days after the end of each quarter with a target of a minimum 95% overall satisfaction rate with key components identified. An assessment of $5,000 per month, which may be paid quarterly, shall be levied against the Contractor for each month the Contractor fails to obtain a 95% overall satisfaction rate as liquidated damages for Contractor’s failure to meet this performance standard.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A31,1)+1","v":"Q-3"},"A communication sent in violation of Part 7.23 Advertising Use and Representation: Contact with State Entities or Part 3.E.11, Communications and Training. The amount at risk is $1,000 per person up to a maximum of $1 million for each violation.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A32,1)+1","v":"Q-4"},"Contractor shall provide written notification of plan changes to impacted members at least 60 days in advance of the effective date of the change. The Contractor will provide draft letters notifying members of the changes to PEBA at least 90 days in advance of the changes and such letters must be approved by PEBA without unreasonable delays but in no case less than 75 days in advance of such change. The amount at risk is $5,000 per plan design change for which notification letters are not postmarked at least 60 days in advance of the change provided PEBA has complied with its notification and approval deadlines.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A33,1)+1","v":"Q-5"},"The Final Implementation Plan, as described in Tab-A-2k Questionnaire, will be submitted to PEBA.","Select one"]
[{"$f":"+\"Q-\"&RIGHT(A34,1)+1","v":"Q-6"},"In addition to the proposed guarantees, Offerors must provide the following guarantees:"]
[null,"a.) All pharmaceutical manufacturer rebate payments required in Part 3.A.8, Pricing and Cost Containment Requirements, and required reporting in Part 3.F.9, Reporting, are provided to PEBA no later than sixty (60) days following the quarter in which rebates are received and any rebates received by the Contractor. Rebates accrued and received by the Contractor or its subcontractor for PEBA utilization not yet paid to PEBA in previous quarterly payments shall be remitted along with the next scheduled quarterly rebate payment. The penalty is $5,000 per day for failing to meet the stated deadline.","Select one"]
[null,"b.) All net PMPM cost guarantees owed to PEBA and required reporting in Part 3.A.6, Pricing and Cost Containment Requirements, are provided to PEBA no later than one-hundred-eighty (180) days after the end of the plan year. The penalty is $5,000 per day for failing to meet the stated deadline.","Select one"]

{"sheet":"A-2n Serv Questionnaire Answers","index":16,"n_rows":107,"n_cols":4,"rows_kept":107,"cut":false,"hidden":true,"merged":[[7,0,7,2],[6,0,6,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-2n: Additional Answers to Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["Instructions: Use this space to continue responses for \"Tab A-2a - Tab A-2m: Service Description Questionnaire\" when answers exceed 1,024 characters in length.  Responses must be numbered to correspond to the question number and section number (Tab A-2a -Tab A-2m) to which it pertains.  "]
[]
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[null,null,null,{"$f":"+LEN(C12)","v":0}]
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[null,null,null,{"$f":"+LEN(C76)","v":0}]
[null,null,null,0]
[null,null,null,0]
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[null,null,null,0]
[null,null,null,0]
[]
[]
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[]
[]
[]
[]
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[]
[]
[]
[]
[]
[null,null,null,0]
[null,null,null,0]
[null,null,null,0]
[null,null,null,0]
[null,null,null,0]
[null,null,null,0]
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{"sheet":"A-3 Subcontractor Questions","index":17,"n_rows":148,"n_cols":3,"rows_kept":148,"cut":false,"hidden":true,"merged":[[7,0,7,2],[8,0,8,2],[10,0,11,1],[10,2,11,2]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-3: Subcontractor Questionnaire"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["Instructions:  Please complete one section of \"Tab A-3: Subcontractor Questionnaire\" for each subcontractor that the Offeror proposes to have perform any of the required functions under this contract.  Clearly indicate if a proposed subcontractor is certified by the State of South Carolina's Office of Small and Minority Business Assistance (OSMBA)."]
[]
[]
["Question",null,"Response"]
[]
["Subcontractor 1"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 2"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 3"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 4"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 5"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 6"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 7"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]
["Subcontractor 8"]
["SQ-1","Provide the following subcontractor information:"]
[null,"a.) Business Name"]
[null,"b.) Address"]
[null,"c.) Phone Number"]
[null,"d.) Taxpayer Identification Number"]
[null,"e.) Point of Contact"]
["SQ-2","Is the subcontractor a South Carolina Certified Minority Business?  If so, please submit a completed the Minority Participation questionnaire located in the RFP  with your proposal."]
["SQ-3","Provide a brief summary of the history of the subcontractor's company and information about the growth of the organization on a national level and within the State of South Carolina."]
["SQ-4","Specifically what role will the subcontractor have in the performance of the Contract?"]
["SQ-5","Please confirm that the Contract has been resolved and is ready for execution upon award.","Select one"]
["SQ-6","a.) Explain the process for monitoring the performance of the subcontractor and measuring the quality of their results."]
[null,"b.) List any services for which the subcontractor will be solely responsible and describe how the subcontractor will be monitored and managed."]
["SQ-7","Describe any significant government action or litigation taken or pending against the subcontractor's company or any entities of the subcontractor's company during the most recent five (5) years."]
["SQ-8","Explain the subcontractor's organization's ownership structure, listing all separate legal entities in chart format.  Describe all major shareholders/owners (10% or greater ownership) and list their percent of total ownership."]
["SQ-9","Does the subcontractor have contractual relationships with third party administrators/organizations in which the subcontractor pays service fees or other fees that you (the Offeror) are directly or indirectly charged for?  If so, identify the outside organizations that receive these service fees and explain the nature of the relationship.\n"]
["SQ-10","What fidelity and surety insurance, general liability and errors and omissions or bond coverage does the subcontractor carry to protect its clients?  Describe the type and amount of each coverage that would protect this plan.  Please furnish a copy of all such policies for review."]

{"sheet":"A-4 Access to Chain Pharmacies","index":18,"n_rows":10,"n_cols":18,"rows_kept":10,"cut":false,"hidden":true,"merged":[[6,0,6,6],[8,1,8,6]],"read":"row_number_cap"}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-4: Access to Network Pharmacies - Chain Pharmacies"]
[]
["Instructions: PEBA is interested in the availability of key chain pharmacies to its participant population using a broad, national network.  Using the table below, provide the requested data for each chain pharmacy included in Your proposed network of pharmacies for the commercial and/or the Medicare Part D plan."]
[]
[]
[null,"Pharmacy Name","Chain Identification","Address Line 1 of Corporate Headquarters","Address Line 2 of Corporate Headquarters","City of Corporate Headquarters","State of Corporate Headquarters","ZIP Code of Corporate Headquarters","Number of  Pharmacy Locations in SC","Number of  Pharmacy Locations Nationwide","Commercial Retail Network Effective Date","Commercial Retail Network Ending Date","Commercial Retail 90 Network Effective Date","Commercial Retail 90 Network Ending Date","EGWP Retail Network Effective Date","EGWP Retail Network Ending Date","EGWP Retail 90 Network Effective Date","EGWP Retail 90 Network Ending Date"]

{"sheet":"A-5 Access to Indep Pharmacies","index":19,"n_rows":10,"n_cols":21,"rows_kept":10,"cut":false,"hidden":true,"merged":[[6,0,6,7],[8,1,8,7]],"read":"row_number_cap"}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-5: Access to Network Pharmacies - Independent Pharmacies"]
[]
["Instructions: The S.C. Public Employee Benefit Authority is interested in the availability of key pharmacies to its participant population using a broad, national network.  Using the table below, provide the requested data for each independent pharmacy included in Your proposed network of pharmacies for the commercial and/or the Medicare Part D plan. "]
[]
[]
[null,"Pharmacy NABP","Pharmacy Name","Pharmacy FEIN","Pharmacy NPI","Address Line 1","Address Line 2","City","County","State","ZIP Code","Phone Number","Compounding Pharmacy Indicator","Commercial Retail Network Effective Date","Commercial Retail Network Ending Date","Commercial Retail 90 Network Effective Date","Commercial Retail 90 Network Ending Date","EGWP Retail Network Effective Date","EGWP Retail Network Ending Date","EGWP Retail 90 Network Effective Date","EGWP Retail 90 Network Ending Date"]

{"sheet":"A-6 Pharm Disruption_Vol","index":20,"n_rows":259,"n_cols":10,"rows_kept":259,"cut":false,"hidden":true,"merged":[[6,0,6,9],[7,8,7,9]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-6: Pharmacy Disruption based on Volume"]
[]
["Instructions: From Confidential Data Exhibit 1, copy and paste the Pharmacy NABP Number, Pharmacy Name, Total Number of Prescriptions, Total Number of Distinct Utilizers, Average Days Supply per Script, Total Quantity, Total Amount Paid and Average Amount Paid per Script into the table below. Then, complete each row by selecting either a \"Yes\" or \"No\" from the drop down list in column I and column J to indicate whether or not the named provider is an in-network provider.  All other responses will be treated as a \"No\" response.  The Offerer may submit \"Attachment A-6&7: Pharmacy Disruption\" to identify any pharmacies listed below that my no longer be  available to the Plan's members.  The Offerer must still identify if the pharmacy was In or Out of Network until it became unavailable.\n\nPharmacy NABP numbers are confidential information and should be treated accordingly.  Please destroy all TIN numbers within 5 business days of award of contract as described in Attachment 1: Non-Disclosure Agreement.\n"]
[null,null,null,null,null,null,null,null,"Member of Network \n(Yes or No)"]
["Pharmacy ID","Pharmacy Name","Total Number of Days of Therapy","Total Number of Distinct Utilizers","Average Days Supply per Script","Rx Count","Total Amount Paid","Average Amount Paid per Script","Standard Plan","Indirect EGWP with Wrap Plan"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]

{"sheet":"A-7 Pharm Disruption_Paid","index":21,"n_rows":259,"n_cols":10,"rows_kept":259,"cut":false,"hidden":true,"merged":[[6,0,6,9],[7,8,7,9]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-7: Pharmacy Disruption based on Total Amount Paid"]
[]
["Instructions: From Confidential Data Exhibit 2, copy and paste the Pharmacy NABP Number, Pharmacy Name, Total Number of Prescriptions, Total Number of Distinct Utilizers, Average Days Supply per Script, Total Quantity, Total Amount Paid and Average Amount Paid per Script into the table below. Then, complete each row by selecting either a \"Yes\" or \"No\" from the drop down list in column I and column J to indicate whether or not the named provider is an in-network provider.  All other responses will be treated as a \"No\" response.  The Offerer may submit \"Attachment A-6&7: Pharmacy Disruption\" to identify any pharmacies listed below that my no longer be  available to the Plan's members.  The Offerer must still identify if the pharmacy was In or Out of Network until it became unavailable.\n\nPharmacy NABP numbers are confidential information and should be treated accordingly.  Please destroy all TIN numbers within 5 business days of award of contract as described in Attachment 1: Non-Disclosure Agreement.\n"]
[null,null,null,null,null,null,null,null,"Member of Network \n(Yes or No)"]
["Pharmacy ID","Pharmacy Name","Total Number of Days of Therapy","Total Number of Distinct Utilizers","Average Days Supply per Script","Rx Count","Total Amount Paid","Average Amount Paid per Script","Standard Plan","Indirect EGWP with Wrap Plan"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,null,null,null,"Select one","Select one"]

{"sheet":"A-8 Formulary Analysis","index":22,"n_rows":264,"n_cols":7,"rows_kept":264,"cut":false,"hidden":true,"merged":[[12,5,12,6],[11,1,11,6],[8,1,8,6],[6,1,6,6],[7,1,7,6],[9,1,9,6],[10,1,10,6]]}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-8: Formulary Analysis"]
[]
["I.","Preferred Drug List - Commercial Plan"]
[null,"Please provide your Preferred Drug List (PDL), including NDC-11 Code, drug name and price per metric quantity, in electronic format using MS Excel with read/write capabilities.  Submit the MS Excel file labeled as \"Tab A-8: Preferred Drug List - Commercial Plan\"."]
["II.","Preferred Drug List - Indirect EGWP"]
[null,"Please provide your Preferred Drug List (PDL) that will be used in conjunction with the Indirect EGWP plan.  The PDL should include NDC-11 Code, drug name and price per metric quantity, in electronic format using MS Excel with read/write capabilities.  Submit the MS Excel file labeled as \"Tab A-8: Preferred Drug List - Indirect EGWP\"."]
["III.","Formulary Analysis"]
[null,"From Confidential Data Exhibit 3, copy and paste the NDC11 Code, Drug Name, Total Days of Therapy and Rx Count into the table below.  The data contains a list of the top 250 drugs utilized by Plan participants during the time period October 1, 2023, through September 30, 2024.  In column F, select the formulary tier applicable for each drug assuming the standard plan, or current program.  In column G, select the formulary tier applicable for each drug under the Indirect EGWP with Wrap plan."]
[null,null,null,null,null,"Formulary Tier"]
[null,"NDC-11","Drug Name","Total Days of Therapy","Rx Count","Standard Plan","Indirect EGWP with Wrap Plan"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]
[null,null,null,null,null,"Select one","Select one"]

{"sheet":"A-9 Performance Guarantees","index":23,"n_rows":39,"n_cols":5,"rows_kept":39,"cut":false,"hidden":true,"merged":[[7,0,7,4],[6,0,6,4]],"read":"row_number_cap"}
[]
[]
[]
[{"$f":"+'A-1 Background and Qual'!A4","v":"Request for Proposal for Pharmacy Benefit Management Services"}]
["Tab A-9: Performance Guarantees"]
[]
["Representations made by the Offeror in this Proposal become contractual obligations that must be met during the contract term."]
["Instructions: As part of the effort toward continuous improvement in the services provided to Members, PEBA would like to implement performance standards with contractors. These standards and accompanying guarantees may be negotiated.  Offeror's shall propose guarantees using the following PEBA specific definitions and measurements outline.  The Offeror shall provide their organization's Proposed Amount at Risk for PG-2 through PG-17.  \n\nOfferors will report results on all performance measurements quarterly per the requirements set forth below.  Performance results will also be audited annually by PEBA's contract auditor."]
[]
[null,"Performance Indicator","Reporting Measurement \n(subject to audit by PEBA and/or contract auditors)","Standard/Goal","Proposed Amount at Risk"]
["PG-1","Average Speed to Answer","a.) The dedicated toll-fee customer service phone line will answer calls within the time specified. Measurement will be from the initial ring.","Within an average of 30 seconds or less"]
[null,null,"b.) The dedicated toll-free customer service phone line shall provide an opt out option to speak with a live customer service representative at any time during the call.  For those Members who require assistance, a live customer service representative will answer calls within the time specified.  Measurement shall be from the point at which the caller requests live assistance via the IVR. ","Within an average of 30 seconds or less"]
["PG-2","Call Abandonment Rate","The call abandonment rate of the dedicated toll-fee customer service phone line will not exceed the specified rate.","3% or less"]
["PG-3","Paper Claims","a.) For the commercial plan, the Contractor will  process reimbursement paper claims not requiring intervention within the guidelines specified.","100% within 14 business days"]
[null,null,"b.) For the EGWP plan, the Contractor will  process reimbursement paper claims not requiring intervention within the guidelines specified.","100% within 14 business days"]
["PG-4","Participant Overall Satisfaction Rate","a) The Contractor will conduct after-call surveys to gauge participant satisfaction on a monthly basis. (See Part 3, Section D.4 of the RFP).  The overall satisfaction rate will meet or exceed the specified goal. After-call satisfaction survey results shall be submitted to PEBA within forty-five (45) days after the end of each quarter","95% or greater","$5,000 per month for each month that the Contractor fails to meet a 95% overall satisfaction rates."]
[null,null,"b) The Contractor will conduct member satisfaction surveys to gauge satisfaction with the Contractor on an annual basis. (See Part III, Section D.5 of the RFP).  The overall satisfaction rate will meet or exceed the specified goal.","95% or greater"]
["PG-5","Automated Claim System Availability Rate","The automated claims system will be available 24 hours a day, 7 days per week.","99.5% or greater"]
["PG-6","Dispensing Accuracy Rate","Home Delivery prescriptions will be dispensed accurately at the specified rate.","99.9% or greater"]
["PG-7","Financial Accuracy Rate","The financial accuracy rate for all prescriptions dispensed at both retail and home delivery pharmacies will be greater than or equal to the specified rate.","99.9% or greater"]
["PG-8","Home Delivery Dispensing Turnaround Time","a.) The Contractor shall dispense all non-protocol prescriptions under the mail service program within the time specified.","average of 2 business days following receipt"]
[null,null,"b.) The Contractor shall dispense all protocol within the time specified.","average of 4 business days following receipt"]
["PG-9","Eligibility Transactions","a.) Processable maintenance eligibility transactions will be processed within the time specified.","within 2 business days"]
[null,null,"b.) For emergencies (retiree is at the retail pharmacy and system shows they are not eligible), eligibility transactions will be processed within the time specified.","same business day if requested during normal business hours; otherwise, within 24 hours"]
["PG-10","ID Card for the Indirect EGWP with Wrap Members","All maintenance ID cards will be mailed within the time specified following receipt of a processable eligibility tape.","99.0% within 4 business days"]
["PG-11","Standard Reporting Package","a.) Standard monthly management/utilization reports will be delivered to PEBA by close of business within the time specified.","within 30 business days following the month's end"]
[null,null,"b.) Standard quarterly management/utilization reports will be delivered to PEBA by close of business within the time specified.","within 45 business days following the quarter's end"]
[null,null,"c.) Standard semi-annual management/utilization reports will be delivered to PEBA by close of business within the time specified.","within 45 business days following the second quarter's end"]
[null,null,"d.) Standard annual management/utilization reports will be delivered to PEBA by close of business within the time specified.","within 45 business days following the Plan Year's end"]
["PG-12","Access Rate","The Contractor shall establish and maintain a network of participating pharmacies to provide service under the retail pharmacy plan.  ","98% of primary eligible Members will have at least one participating pharmacy within 5 miles of their home ZIP code where any retail pharmacy exists within 5 miles of their home ZIP Code."]
["PG-13","Decline in Participating Pharmacies","Unless Contractor and PEBA mutually agree to limit the retail network in order to meet cost or quality objectives during the contract period, the network of participating pharmacies should not decrease in size by more than the specified percentage on an annual basis.","5.0% or less"]
["PG-14","Notices of Creditable and Non-Creditable Coverage","Annually, the Contractor will use eligibility files furnished by client to mail personal notices to Medicare Plan Members notifying them of creditable or non-creditable prescription drug coverage. (This would only apply to mailings where complete and accurate requirements are received and approved based on a mutually agreed upon date between contractor and the State which will allow appropriate time to complete the mailings.  This is based on receipt of a clean and accurate electronic Eligibility file by a mutually agreed upon date between PBM and the State to support the mailing.)","100% of mailings will be made on or before October 31st of each year. "]
["PG-15","Final Reconciliation","The Contractor will calculate and submit final cost reports to client for client's review in order to complete Final Reconciliation of the current Retiree Drug Subsidy claim.","On or before the tenth workday following the date contractor and client finalize the covered retiree list during Final Reconciliation"]
["PG-16","Monthly Cost Reports","The Contractor will submit monthly cost reports for client's review and submission of RDS payment request. ","On or before the 21st calendar day of the month following the reporting month."]
["PG-17","Final Implementation Plan","The Final Implementation Plan, as described in Tab-A-2k Questionnaire will be submitted to PEBA.","No later than thirty (30) calendar days following final award.","$5,000 per day for each day or partial day during which the Contractor is not in compliance with the FIP."]
["PG-18","Rebate Payments","All pharmaceutical manufacturer rebate payments required in Part 3.A.8, Pricing and Cost Containment Requirements, and required reporting in Part 3.F.9, Reporting, are provided to PEBA no later than sixty (60) days following the quarter in which rebates are received and any rebates received by the Contractor. Rebates accrued and received by the Contractor or its subcontractor for PEBA utilization not yet paid to PEBA in previous quarterly payments shall be remitted along with the next scheduled quarterly rebate payment.","Guarantees - 60 days following end of the quarter\nIBNR claims - Next scheduled payment","$5,000 per day owed to PEBA."]
["PG-19","PMPM Cost Guarantees","All net PMPM cost guarantees owed to PEBA and required in Part 3.A.6, Pricing and Cost Containment Requirements, are provided to PEBA no later than one-hundred-eighty (180) days after the end of the Plan Year.","No later than 180 days after the end of the Plan year.","$5,000 per day owed to PEBA."]
["PG-20","Written Notification of Plan Changes","Contractor shall provide written notification of plan changes to impacted members at least 60 days in advance of the effective date of the change. The Contractor will provide draft letters notifying members of the changes to PEBA at least 90 days in advance of the changes and such letters must be approved by PEBA without unreasonable delays but in no case less than 75 days in advance of such change.","Member notification at least 60 days;\nPEBA notification at least 90 days","$5,000 per plan design change for which notification letters are not postmarked at least 60 days in advance of the change provided PEBA has complied with its notification and approval deadlines."]
["PG-21","Marketing Plan","Contractor shall develop an annual marketing plan by February 1 of each year. The Contractor shall develop a review schedule in collaboration with PEBA to meet the February 1 deadline. The plan must be approved by PEBA by February 1 of each year; such approval will not be unreasonably withheld.","On or before February 1st of each year.","$5,000 for failing to meet the stated deadlines."]