STRATEGIC PRIORITY: Core
AGENDA DATE: June 11, 2025
COUNCIL DISTRICT(S): N/A
DEPARTMENT: Office of Procurement Services
EXECUTIVE: Donzell Gipson
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SUBJECT
Title
Authorize a three-year service contract, with two one-year renewal options, for pharmacy benefit management services for the Department of Human Resources - Blue Cross Blue Shield of Texas, a Mutual League Company, most advantageous proposer of ten - Not to exceed $2,221,440.00 - Financing: Employee Health Benefits Fund (subject to annual appropriations)
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BACKGROUND
This action does not encumber funds; the purpose of a service contract is to establish firm pricing for services, for a specific term, which are ordered on an as needed basis.
This service contract will provide for pharmacy benefit management services for the Department of Human Resources. The contract also provides claims processing, coordination of benefits, and compliance with HIPPA standards, while also maintaining retail, mail order, and specialty pharmacy network.
The scope includes formulary management, ensuring cost-effective drug coverage, and administration of rebate programs. This service contract will offer clinical services such as drug utilization reviews, prior authorization processing, and fraud prevention. As well as providing implementation and benefit support, account management, reporting, and pharmacy financial accumulators. Member tools, such as a help line, web and mobile resources, and printed materials, will be available.
The City currently insures approximately 13,000 employees and has approximately 2,000 pre-65 retirees and 3,000 post-65 retirees totaling approximately 18,000 eligible employees for the City's medical plan benefits.
The City pays approximately 60 percent of the health care plan cost with employees and retirees paying the remaining 40 percent of the cost. The benefits program is structured on a calendar-year basis. Dur...
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