REQUEST FOR PROPOSAL 
FOR THE STATE OF WISCONSIN
Department of Employee Trust Funds (ETF)
Administrative Services for the State of Wisconsin Pharmacy Benefit Program
ETG0013

This Request for Proposal (RFP) is issued by the Wisconsin Department of Employee Trust Funds (ETF) on behalf of the State of Wisconsin Group Insurance Board (Board). The purpose of this RFP is to provide interested and qualified vendors with information to enable them to prepare and submit competitive proposals to administer pharmacy benefits as the Pharmacy Benefit Manager (PBM) for the State of Wisconsin Group Health Insurance Program (GHIP) and the Wisconsin Public Employer (WPE) program for local government employees, managed by ETF. ETF administers retirement, health, life, disability, and long-term care insurance programs for over 570,000 State and local government employees and annuitants.

ETF intends to use the results of this RFP solicitation to award a contract for Administrative Services for the State of Wisconsin Pharmacy Benefit Program. The contract will be administered and managed by ETF, with oversight by the Board.

The contract term will commence on January 1, 2018, and shall extend through December 31, 2020. The Board retains the option, by mutual agreement of the Board and the successful proposer, to renew the contract for two (2) additional two (2)-year periods extending the contract through December 31, 2024, subject to the satisfactory negotiation of terms, including pricing.

This RFP details the procedures proposers must follow to submit a proposal for Administrative Services for the State of Wisconsin Pharmacy Benefit Program for ETF, and the minimum requirements that proposers must meet to be eligible for consideration. There are several different submission requirements proposers must follow in order to submit a proposal. Proposers must submit forms to the Board’s actuary, Segal Consulting (Segal), and ETF in order to receive data files to complete proposals. Proposers must submit their written proposal (and other documents) to ETF, while the cost proposal (and other documents) must be submitted to Segal. Please review the specific requirements in Sections 2 and 8 in the RFP for further details and instructions.

This solicitation is authorized under Chapter 40 of the Wisconsin State Statutes. All decisions and actions under this RFP are solely under the authority of the Board. Procurement statutes and rules that govern other State agencies may not be applicable.

Any news releases or release of broadcast e-mails pertaining to this RFP, resulting contract, or to the acceptance, rejection, or evaluation, or review of proposals shall not be made without the prior written approval of the State of Wisconsin or ETF.

The deadline for receipt of proposals for this RFP is Wednesday, January 25, 2017 at 2:00 p.m. CST. Late submissions will not be considered. Questions may be submitted as indicated in the RFP via email to ETFSMBProcurement@etf.wi.gov.

All modifications and other information associated with this RFP will be posted on this web site. As such, interested vendors are encouraged to check this web site for updates frequently. No other notification regarding modifications will be provided.

Uploaded Documents

ETG0013 RFP
Appendix 1 - 834 Companion Guide
Appendix 2 - Data Specifications - Pharmacy
Appendix 3 - StayWell Standard Export File Layouts
Appendix 4 - Data Specifications - Medical
Appendix 5 - Data Specifications - Dental
Appendix 6 - State Employer Group Roster (ET-1404)
Appendix 7 - Local Employer Group Roster (ET-1407)
Appendix 8 - Health Insurance Fact Sheet (ET-8902)
Appendix 9 - Pharmacy Benefit Fact Sheet (ET-8933)
Appendix 10 - Data warehouse and visual business intelligence data flow
Attachment F - Cost Proposal
Attachment G - Commercial Formulary
Attachment H - EGWP Formulary
Attachment I - Formulary Companion Guide
ETG0013 Addendum #3
ETG0013 Addendum #2
ETG0013 Addendum #3
Exhibit 1 - Pro Forma State of Wisconsin Contract
Exhibit 1 - State of Wisconsin Pharmacy Benefit Program Agreement 1.4.2017
Exhibit 2 - Standard Terms and Conditions (DOA-3054)
Exhibit 3 - Supplemental Standard Terms and Conditions (DOA-3681)
Exhibit 4 - Department Terms and Conditions
Form A - Proposer Checklist
Form B - Mandatory Proposer Qualifications
Form C - Subcontractor Information
Form D - Proposer Verification of Data Submission to Board Actuary
Form E - Designation of Confidential and Proprietary Information (DOA-3027)
Form F - Non-Disclosure Agreement (NDA)
Form G - Request for Proposal (DOA-3261)
Form H - Vendor Information (DOA-3477)
Form I - Vendor References (DOA-3478)
ETG0013 Contract
ETG0013 Amendment 1
ETG0013 Amendment 2 - redacted formulary
ETG0013 Amendment 3
ETG0013 Amendment 4 - redacted formulary
ETG0013 Amendment 5
ETG0013 Amendment 6
ETG0013 Amendment 7