RFP 2000004081 Administration of Medical and Vision Plans and Pharmacy Benefits Management

Background
The Fairfax County Public Schools (FCPS) is seeking proposals to establish a contract for the administration of medical and vision plans, as well as pharmacy benefits management. The goal of this Request for Proposal (RFP) is to provide essential health benefits to eligible employees and retirees of FCPS, ensuring compliance with federal and state mandates.

Work Details
The contract will include the following services:

1. Administration of Medical and Vision Plans - Administrative Services Only (ASO) for FCPS's self-insured medical and vision plans, which encompasses network management, disease management, claims processing and payment, and operational compliance with applicable regulations. These services are intended for benefits-eligible employees, non-Medicare eligible retirees, and their dependents.

2. Pharmacy Benefit Management (PBM) - This includes prescription drug coverage offered either on an integrated basis or carved out from the self-insured medical plan. PBM services must cater to eligible employees, retirees, and dependents of FCPS's self-insured health benefits plan, including Medicare-eligible retirees. The successful Offeror must administer PBM benefits on an ASO basis and manage an Employee Group Waiver Plan (EGWP) for Medicare-eligible participants.

Period of Performance
The contract period will commence upon award and is expected to last until the completion of the specified services as outlined in the RFP. Proposals are due by March 21, 2025.

Place of Performance
Services will be performed primarily in Falls Church, Virginia, where Fairfax County Public Schools is located.