Pharmacy Benefit Management Services
ARFP PEI2100000006​

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Attachments and Exhibits Download PBM RFP 2021.zip
Contains the following:

Attachment 1: Sample Monthly Plan Performance
Attachment 2: Sample Top Drugs Report
Attachment 3: Sample Top Therapeutic Classes
Attachment 4: Sample Tobacco Cessation Report
Attachment 5: Sample Specialty Medication Report
Attachment 6: Sample Top Drug Report for Actuaries

Exhibit G: Business Associate Addendum
Exhibit I: Limited Data Use Agreement
Exhibit J: Purchasing Affidavit
Exhibit K: Bidder Litigation Waiver Form
Exhibit L: Data Management Addendum
Exhibit M: WV-96
Exhibit N: Notification of Interest Form​