Lee County Southwest Florida #RFP230580CJV

Lee County Awards Employee Group Medical and Pharmacy Benefits Administration to Aetna Life Insurance Company

Lee County, Florida is awarding a comprehensive contract for employee group medical and pharmacy benefits administration, led by Aetna Life Insurance Company as the primary OEM and service provider. - Government Buyer: - Lee County Board of County Commissioners (Human Resources Department, Division of Procurement Management) - OEMs and Vendors: - Aetna Life Insurance Company (primary OEM and administrator) - CaremarkPCS Health, L.L.C. (CVS Caremark, pharmacy benefit manager and Aetna affiliate) - PrudentRx (optional third-party copay optimization service) - Products/Services Requested: - Integrated administration of group medical and pharmacy benefits for approximately 4,100 employees - Includes claims processing, network access, wellness programs, reporting, and behavioral health services - Pharmacy benefit management (retail, mail order, specialty drugs, formulary management, rebates) - Specialty drug management through CVS Specialty Pharmacies (with exceptions for HIV drugs) - Case management, care management, and wellness incentive programs - Technology and web tools for members and providers - Optional PrudentRx Copay Optimization for specialty drugs - Notable Requirements: - Transparent/pass-through pricing for pharmacy claims - Administrative fees starting at $40.40 per employee per month, with annual increases - Fee holiday credits, communication/wellness/audit allowances, and detailed claims data reporting - Market check provision for pricing adjustments based on market conditions - Compliance with Florida Statute 624.428 (vendors must be carriers, not brokers/agents) - Plan must be offered as a combined medical and pharmacy package - Annual reconciliation of rebates and fees, with audit rights - Period of Performance: - Initial three-year term starting January 1, 2025, with up to three additional one-year renewals (potentially through 2030) - Locations: - Lee County, Florida (place of performance) - Lee County Procurement Management, 2115 Second Street, 1st Floor, Fort Myers, FL 33901 (contracting office) - 4630 Woodlands Corporate Blvd., Tampa, FL 33614 (service center)

Description

This solicitation is for the Employee Benefits - Group Medical and Pharmacy Plan for Lee County, Florida. The contract awarded to Aetna Life Insurance Company covers group medical and pharmacy benefits for an initial term of three years starting January 1, 2025, with up to three additional one-year renewals. The contract includes administrative fees, fee holiday credits, communication and wellness allowances, and audit allowances. The solicitation involves providing all necessary labor, services, materials, equipment, and incidentals required for the plan.

View original listing