CLARK COUNTY BOARD OF COMMISSIONERS
AGENDA ITEM
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Petitioner: |
Les Lee Shell, Deputy County Manager |
Recommendation:
title
Approve an Amendment to the Contract with Navitus Health Solutions, LLC, for RFP No. 604027-16, for Prescription Benefits Manager Services for Clark County's Self-Funded Prescription Drug Plan; and authorize the Chief Financial Officer or her designee to sign the Amendment; or take other action as appropriate. (For possible action)
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FISCAL IMPACT:
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Fund #: |
6520.500 |
Fund Name: |
Self -Funded Group Insurance |
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Fund Center: |
1020520000 |
Funded PGM/Grant: |
N/A |
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Amount: |
No Cost |
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Description: |
Prescription Benefits Manager Services for Clark County’s Self-Funded Prescription Drug Plan |
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Additional Comments: |
The initial Contract amount was $4,939,310.77. Amendment No. 1 had no fiscal impact. Amendment No. 2 had no fiscal impact. Amendment No. 3 increased the Contract amount by $354,757.20. Amendment No. 4 increased the Contract amount by $2,265,550. Amendment No. 5 will have no fiscal impact for a new total Contract amount of $7,559,617.97, should all renewal options be exercised. The total Contract amount is subject to change as it is based on a per member per month cost of all eligible employees and retirees enrolled in the Clark County Self-Funded Health Benefit Plan and the Clark County Self-Funded Exclusive Provider Organization (EPO) Plan. |
BACKGROUND:
On August 2, 2016, the Board of County Commissioners (Board) approved the award of RFP No. 604027-16 to Navitus Health Solutions, LLC (LBE) in the amount of $4,939,310.77 for Prescription Benefit Manager Services.
The following are the pertinent provisions of the Contract:
• The term of the Contract was from date of award through December 31, 2017, and included the option to renew for 6, one-year periods. There are 2 renewal options remaining per Amendment No. 4.
• Included the County’s option to terminate for cause, convenience or default and suspend the Contract with advanced written notice.
Amendment No. 1 allowed for the addition of an appeals process for members.
Amendment No. 2 provided for the inclusion of Electronic Real Time Benefit Tools (RTBT) in compliance with the electronic real time tool standards put in place by the Centers for Medicare and Medicaid Services for 2021. This included a passthrough vendor transaction cost.
Amendment No. 3 added the Clark County Exclusive Provider Organization (EPO) Plan to the Contract as well as a $.40 per person per month Rebate administration fee.
Amendment No. 4 provided for the addition of the Copay Max Program for both plans and added 2 renewal terms to the Contract for a total of 8 renewal terms through December 31, 2025.
Approval of Amendment No. 5 will provide for additional reporting of the Consolidated Appropriations Act (CAA) RxDC report. The attached Amendment No. 5 document details the modifications and costs involved.
Navitus Health Solutions, LLC currently holds a Clark County Business License.