State Of Mississippi State And School Employees' Health Insurance Management Board

The buyer seeks a qualified vendor to provide pharmacy benefit management services for its self-insured health plan covering approximately 190,000 participants. The buyer requires a customized formulary, clinical programs for cost containment, and full transparency on rebates and pricing. Services include claims processing, network management, mail order, specialty pharmacy, reporting, and drug utilization reviews. The contract term is for 5 years beginning January 1, 2026.

• 10/16/2024 - Proposal Due Date

• Possess at least 8 years experience providing similar pharmacy benefit management services
• Provide services to at least 1 million covered lives in book of business
• Provide services to one employer client with at least 100,000 covered lives
• Agree to provide services within the United States
• Comply with Mississippi laws regarding transparency and rebate pass-through

• Provide pharmacy benefit management services for self-insured health plan
• Administer prescription drug claims processing and payment
• Manage pharmacy network and negotiate pharmaceutical pricing
• Implement clinical programs for cost containment
• Provide mail order and specialty pharmacy services
• Develop and manage customized formulary
• Conduct drug utilization reviews
• Provide reporting and data analytics
• Manage rebates from pharmaceutical manufacturers
• Implement patient adherence and education programs