Medical Third Party Administration and Pharmacy Benefit Management Services

RFP Release Date: April 14th, 2026

Vendor Questions Due: April 23rd, 2026

RFP Due Date: May 6th, 2026

Vendor Interviews: May 14th, 2026

Award Date: June 2026

Effective Date: January 1st, 2027

A vendor is sought to provide comprehensive medical third-party administration and pharmacy benefit management services for a self-funded health plan. Key responsibilities include administering medical and pharmacy claims with transparent acquisition cost methodologies, ensuring full pass-through of all discounts, rebates, and fees, and compliance with all applicable federal and state regulations.

The selected partner will deliver transparent reporting, facilitate data integration and analytics to support informed decision-making, and provide cost-effective solutions that meet both short- and long-term financial goals. The contract will require effective network management, accurate claims adjudication, and pharmacy cost containment strategies to deliver measurable improvements in service performance, member experience, and clinical outcomes.

Vendors must be capable of managing retail and mail-order pharmacy claims with full disclosure and pass-through of all cost components, and should offer traditional PPO plan options as well as high-deductible health plans with HSA eligibility. The engagement will span a three-year period, focusing on operational efficiency, regulatory compliance, cost containment, and high-quality service.