RFP #CCHR2026-2 Pharmacy Benefit Management Services

Location:	New York
Posted:	Apr 21, 2026
Due:	May 22, 2026
Agency:	Cattaraugus County
Type of Government:	State & Local
Category:	Q - Medical Services
Publication URL:	To access bid details, please log in.

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Cattaraugus County

Pharmacy Benefit Management Services

RFP # CCHR2026-2

Proposed Effective Date: January 1st, 2027

Presented by:

Arthur J. Gallagher & Co.

90A John Muir Dr

Amherst, NY 14228

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Table of Contents

Table of Contents................................................................................................................. - 2 -

Confidentiality ...................................................................................................................... - 3 -

Introduction .......................................................................................................................... - 4 -

Objective............................................................................................................................... - 6 -

Instructions .......................................................................................................................... - 7 -

PBM Corporate Information & References ......................................................................... - 8 -

Minimum Contractual Requirements .................................................................................. - 9 -

Written Response Questions ............................................................................................ - 15 -

Fulfillment........................................................................................................................... - 18 -

Shipping ............................................................................................................................. - 19 -

Clinical Services ................................................................................................................ - 20 -

Formulary........................................................................................................................ - 20 -

Prior Authorizations ....................................................................................................... - 21 -

Step Therapy................................................................................................................... - 21 -

Quantity Level Limitations ............................................................................................. - 21 -

Utilization Management.................................................................................................. - 22 -

Incretin Mimetics ............................................................................................................ - 22 -

Specialty Medications .................................................................................................... - 23 -

Opioid Management/Fraud, Waste, Abuse ................................................................... - 24 -

Adherence....................................................................................................................... - 24 -

Compounding ................................................................................................................. - 24 -

Pharmacogenomics ....................................................................................................... - 24 -

International & Alternative Drug Sourcing.................................................................... - 25 -

Other................................................................................................................................ - 25 -

Fees ................................................................................................................................. - 25 -

Member Service ................................................................................................................. - 26 -

Reporting and Website Capabilities ................................................................................. - 27 -

Data Requirements ............................................................................................................ - 29 -

Formulary and Pharmacy Comparison............................................................................. - 30 -

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Confidentiality

This Request for Proposal (RFP #CCHR2026-2) and all information contained herein, any

attachments or exhibits hereto, and all communications in whatever media form, in support of this

document are proprietary to Cattaraugus County (“the Client”). Your firm acknowledges the

proprietary nature of the aforementioned described information and that your use of such

information for purposes other than a vendor/vendee relationship, or the disclosure of such

proprietary information to third parties other than for the purpose of advancing the intent of the

services contemplated by this document will cause irreparable injury to Cattaraugus County.

Vendor’s breach of this covenant pertaining to the proprietary information will entitle Cattaraugus

County to automatic injunctive relief in addition to any and all other remedies available at law.

Acknowledgment

_____________________________

Name

______________________________

Company

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Introduction

Cattaraugus County will be involved in the selection of a Pharmacy Benefit Manager (PBM)

offering a comprehensive pharmacy benefit management solution for their approximately 967

employees and 2,489 members (including employees). The self-funded prescription plan

currently includes active employees, Pre-65 Retirees and COBRA members. Gallagher (“the

Consultant”) is requesting on their behalf self-funded proposal for the administration of

pharmacy benefit management to Cattaraugus County (“the Client”). The response to this RFP

will determine the PBM best suited to assist the Client.

The client is looking for a two-year contract with a proposed effective date of January 1st, 2027.

Also, Cattaraugus County will be looking for a contract that provides for a market check to

review the competitiveness of their contract with the selected PBM after the first 12 months of

the contract. This Request for Proposal (RFP) will be asking for information about clinical

management, data management, as well as financial offerings. The overall purpose of this RFP

is to evaluate the capabilities of selected PBM's to meet the specific needs of the Client.

The bidding PBM will need to take into account the required integration with other benefit

providers including but not limited to Medical, Disease Management and Data Aggregation

vendors. The chosen administrator will be expected to bear the cost of preparation and

installation of appropriate administrative systems, contract preparation, billing, network

enhancements, related administrative manuals, enrollment forms, and communication with

employees and providers.

Nothing contained in this RFP creates, nor shall be construed to create, any contractual

relationship between the Client and any vendor. The Client makes no commitment in or by

virtue of this RFP to purchase any services or items from any vendor. Nor does receipt of your

proposal place the Client under obligation to enter into an agreement to purchase services from

your organization.

Your proposal shall become the sole and exclusive property of the Client. The Client reserves

the right to modify, reject, or use without limitation any or all of the ideas from the proposals.

The Client will not disclose the pricing contained in any proposal to any party other than its

attorneys, representatives, or consultants except as may be necessary to complete a blind

analysis of responses provided to this RFP. Vendors from whom proposals are solicited may not

discuss this RFP with anyone outside their own organization other than authorized the Client

personnel and, or their designee(s).

If your organization is selected to provide the outlined services, you may not advertise or publish

the fact that the Client has selected your company as their partner without written permission

from the Client. You are not allowed to use the Client name or any trademark of the Client in

any advertising or publication or other communication, other than in your proposal, without the

prior written consent of the Client.

Expenses incurred in preparing and presenting a proposal to the Client is the sole responsibility

of the vendor and may not be charged to the Client in anyway. This RFP is an invitation to share

information about your business model, clinical programs, and general insight into the

pharmaceutical marketplace which will help the Client determine which PBM(s) is best suited to

help them manage their plan. All aspects of the Client business to which you may have access

as a result of this RFP are considered strictly confidential.

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The Client is specifically interested in how the PBM performs in the following areas:

a) Discount guarantees with per-unit price stability

b) Administrative fee structure

c) Maximizing generic utilization

d) Percentage of earned rebates to the Client with minimum floor guaranteed

rebates, without overutilization of brand drugs

e) Performance Guarantees

f) Stable and decreasing PMPM (per member per month) spending trend

g) Stable formulary, focused on lowest net cost drugs

h) Drug monitoring and utilization review programs

i) Innovative programs, such as therapeutic mac, disease management,

therapeutic interchange programs, limited network strategies, retail pharmacy

partnerships, etc.

j) Periodic reviews – financial, clinical, market, strategic

k) Effective customer, client, and consultant communications and messaging.

l) Mail cost savings opportunities with incentives programs

m) Organizational stability and experience

n) Customer service representative and account manager capabilities.

o) Ability to work with the selected third-party claims administrators, data

aggregators, consultant and other entities that may be involved with the

administration of the health plan to provide up to daily electronic exchanges of

eligibility, and claims information

p) Online member information resources, including mobile applications

q) Biosimilar net cost strategy including guarantees, utilization management and

formulary placement

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This is the opportunity summary page. It provides an overview of this opportunity and a preview of the attached documentation.

RFP #CCHR2026-2 Pharmacy Benefit Management Services

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See also