The government authority in New Hampshire is seeking a qualified vendor to provide comprehensive prescription drug administration services for its self-funded Employee and Retiree Health Benefit Plan. The selected partner will function as the pharmacy benefits manager (PBM), responsible for ensuring high-quality, cost-effective, and transparent prescription drug benefits for plan participants and their dependents.

Key responsibilities include claims adjudication, maintaining member enrollment and eligibility, integration of PBM services with other state programs such as medical and wellness initiatives, and providing education for patients and providers. Other expectations involve systematic drug utilization review, network pharmacy contracting and management, mail order and specialty pharmacy operations, clinical and cost management programs, as well as formulary management and rebate administration.

The PBM will also be tasked with robust data sharing and reporting (standard and ad hoc), distribution of ID cards, access to pharmacy directories, and delivering comprehensive member and account services including help desk, call center, website, portal, and mobile app support. The contractor must also provide online systems for the State and its designated representatives.