Agenda 10/22/2019 Item #16E1 (Renewing Agreement #16-0036)10/22/2019
EXECUTIVE SUMMARY
Recommendation to renew Agreement #16-0036, Pharmacy Benefit Management Services, with
Envision Pharmaceutical Services, LLC and to amend the current Agreement to reflect improved
terms effective January 1, 2020.
OBJECTIVE: To provide Pharmacy Benefit Management services to the Collier County Group Health
Insurance Plan.
CONSIDERATIONS: The Board of Commissioners, through its Risk Management Division,
administers a partially self-funded group health insurance plan (the “Plan”) for its employees and their
covered dependents. A significant component of the Plan provides coverage for prescription medications
through a Pharmacy Benefit Management program or “PBM.” A PBM leverages large numbers of
covered lives to negotiate favorable pricing terms from manufacturers and retail distributors for the Plans
they service.
On September 24, 2013 (Agenda Item #11G), the Board approved an Agreement with Envision
Pharmaceutical Services, Inc. (“Envision”) for pharmacy benefit management services. In 2016, RFP#
16-0036 was released and on September 13, 2016 (Agenda Item #16E8) the Board approved an
Amendment to the original agreement with updated pricing and contract dates that allowed the contract to
be valid through December 31, 2020.
The pharmacy market is ever changing as medications transfer from brand to generic and as the market
offers incentives to buyers. At the request of staff, the County’s Benefits and Actuarial Consultant, Willis
Towers Watson reviewed the current pricing terms of the agreement and recommends that the Agreement
be amended to reflect improved pricing opportunities available in the market effective January 1, 2020.
Willis Towers Watson completed its review and identified opportunities that could result in savings to the
Plan of up to $1,500,000 when compared to the current pricing schedule.
A 2020 Amendment to the Agreement is attached that reflects these improved pricing opportunities.
Envision is amenable to continue utilizing the existing Agreement with the proposed new terms through
the end of the final renewal period which starts on January 1, 2020 and ends December 31, 2020.
FISCAL IMPACT: It is estimated that the new rates could result in total savings of $1,500,000 to the
Board’s Health Insurance Program when compared to the current terms. Funds are budgeted within Fund
517, Group Health and Life, Insurance Claims for this purpose.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this
item.
LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires
majority vote for approval.-SRT
RECOMMENDATION: To exercise the option to renew Agreement #16-0036, Pharmacy Benefit
Management Services, with Envision Pharmaceutical Services, LLC., approve the attached Amendment
to the Agreement to reflect improved terms effective January 1, 2020, and authorize the Chairman to
execute the Amendment.
Prepared by: Sonja Sweet, Group Insurance Manager, Risk Management
ATTACHMENT(S)
1. 2013 Pharmacy Benefit Mgmt Serv Agreement (PDF)
2. 2016 Pharmacy Benefit Amendment RFP# 16-0036 (PDF)
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10/22/2019
3. 2020 Amendment to 16-0036 Envision_Amend_VendorSigned_ (PDF)
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10/22/2019
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.1
Doc ID: 9923
Item Summary: Recommendation to renew Agreement # 16-0036, Pharmacy Benefit
Management Services, with Envision Pharmaceutical Services, LLC, and to amend the current Agreement
to reflect improved terms effective January 1, 2020.
Meeting Date: 10/22/2019
Prepared by:
Title: Benefits Analyst – Risk Management
Name: Sonja Sweet
09/25/2019 12:19 PM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
09/25/2019 12:19 PM
Approved By:
Review:
Risk Management Jeff Walker Additional Reviewer Completed 09/25/2019 2:15 PM
Procurement Services Opal Vann Level 1 Purchasing Gatekeeper Completed 09/25/2019 4:57 PM
Administrative Services Department Michael Cox Level 1 Division Reviewer Completed 09/26/2019 6:11 AM
Procurement Services Priscilla Doria Additional Reviewer Completed 10/01/2019 1:31 PM
Procurement Services Evelyn Colon Additional Reviewer Completed 10/03/2019 9:39 AM
Procurement Services Ted Coyman Additional Reviewer Completed 10/04/2019 5:24 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 10/07/2019 5:16 PM
County Attorney's Office Scott Teach Level 2 Attorney Review Completed 10/09/2019 4:58 PM
Office of Management and Budget Laura Wells Level 3 OMB Gatekeeper Review Completed 10/10/2019 9:48 AM
County Attorney's Office Scott Teach Level 3 County Attorney's Office Review Completed 10/10/2019 10:43 AM
Budget and Management Office Mark Isackson Additional Reviewer Completed 10/10/2019 2:40 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 10/12/2019 11:49 AM
Board of County Commissioners MaryJo Brock Meeting Pending 10/22/2019 9:00 AM
16.E.1
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Packet Pg. 2437 Attachment: 2013 Pharmacy Benefit Mgmt Serv Agreement (9923 : Pharmacy Benefit Amendment)
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Re
Date:October 21,2016
To:Camille Shim-Marinos
Procurement Services
From:Teresa Cannon, Deputy Clerk
Minutes & Records Department
Amendment #3 to Contract #16-0036 "Pharmacy Benefit
Management Services Agreement"
Contractor: Envision Pharmaceutical Services, Inc.
Attached is an original ofthe document referenced above, (Item #16E8) approved by
the Board of County Commissioners on Tuesday, September 13,2016.
The second original has been held by the Minutes and Records Department as part of
the Board's Official Record.
Ifyou have any questions, please contact me at252-8411.
Thank you.
Attachment
MEMORANDUM
16.E.1.b
Packet Pg. 2473 Attachment: 2016 Pharmacy Benefit Amendment RFP# 16-0036 (9923 : Pharmacy Benefit Amendment)
3
Amendment #{to6(Pharmacy Benefit Management Services Agreement"
This Amendment, dated tl 't ,2016 to the referenced Agreement shall be by and between the
parties to the original Agree(nent, dated January 1,2014, Envision Pharmaceutical Services, Inc., an Ohio
Corporation, (to be referred to as "Envision") and Collier County Board of Commissioners, a political
subdivision of the State of Florida (to be referred to as "Plan Sponsor").
Statement of Understanding
RE: "Pharmacy Benefit Management Services Agreement"
The parties hereby agree to amend the Agreement as provided below:
Chanee # 1: Exhibit I Drug Pricing and Fees is replaced in its entirety with the attached "Update to
Exhibit I " effective January I ,2017 ,
Chanee # 2: Subsection 6.1 Term, is hereby replaced in its entirety with the following:
6.1. Term: The term of this Agreement shall commence on January 1,2017 and shall remain in full force
and effect for an initial term of two (2) years ("Initial Term") unless earlier terminated as provided herein.
Upon the expiration of the Initial Term, this Agreement may be renewed for two additional (1) one year
terms, subject to the mutual approval by the parties, in writing, at least ninety (90) days prior to the
commencement of each renewal term. If either paffy hereto does not notify the other in writing according
to the renewal notice provision, the Agreement will terminate at the end of the current term.
All other terms and conditions of the agreement shall remain in force.
IN WITNESS WHEREOF, the parties have each, respectively, by an authorized person or agent, have
executed,this Arqendment on the date(s) indicated below.
Dwight E.
OF COUNTY COMMISSIONERS
OF CO
Fiala, Chairman
uMv,FLoRIDAd,/*
a$
.-.. signature only
First Witne"ss:
By:lLu--
ft1r, soa. \c<-L t e'l
Inc.
Print Name
Second Witness:Print Name and Title
to Form and
Print Name County
riec
U6-PRC-0313011277256111 Languagedeletedhasbeenstnrekth+engh. Newlanguagehasbeenunderlined.
@
AcceptedS"{>\**\a<y \j,2016
Brock, Clerli
16.E.1.b
Packet Pg. 2474 Attachment: 2016 Pharmacy Benefit Amendment RFP# 16-0036 (9923 : Pharmacy Benefit Amendment)
a a rtl\lur.ac) turaclr/\/L- L-C MEN VIf ION B.
Collier County Board of Commissioners
PHARMACY BENEFIT MANAGEMENT SERVICES AGREEMENT
Update to Exhibit 1
Effective January'1,, 2017
The rates and terms set forth below replace the same rates and terms of any prior Exhibit 1 as of the
effective date above [i.e. the changes set forth herein are not retroactive).
For Contract Year
20L7
Drug Pliss (n)
fAnnual Average
Effective Rate
Guarantee)
Dispensing
pss (o)
(Annual
Average
Guarantee)
Drug Price(c)
(Annual Average
Effective Rate
Guarantee)
Dispensing
['ss (o)
(Annual
Average
Guarantee)
30 Days'Supply at a
Retail Pharmacy
AWP minus L7o/o
[Non-legend Drugs
AWP minus
!6.75o/o)
[Specialty Drugs:
AWP minus
L6.500/o)
$1.15
AWP minus B0%
(Non-legend Drugs
AWP minus
16.75o/o)
(Specialty Drugs:
AWP minus
16.50o/o)
$1.15
90 Days'Supply at a
Retail Pharmacy
AWP minusZZo/o
(Non-legend Drugs
AWP minus22o/o)
[Specialty Drugs:
AWP minus
16.500/o)
N/A
AWP minus B2o/o
[Non-legend Drugs
AWP minus22o/o)
[Specialty Drugs:
AWP minus
16.50o/o)
N/A
Mail Order Pharmacy
fat Orchard
Pharmaceutical
Services)
AWP minus24o/o
[Non-legend Drugs
AWP minus 240/o)
[Specialty Drugs:
AWP minus
\6.75o/o)
N/A
AWP minus 83%
[Non-legend Drugs
AWP minus24o/o)
[Specialty Drugs:
AWP minus
1,6.75o/o)
N/A
Specialty Pharmacy
[at Orchard fPass-Through of Contract Rate with Dispensing Pharmacy)
*r
2Glearly. Beneficial.
16.E.1.b
Packet Pg. 2475 Attachment: 2016 Pharmacy Benefit Amendment RFP# 16-0036 (9923 : Pharmacy Benefit Amendment)
ENVI'IONB.a a
lurac I
Em
4r
uriac
Pharmaceutical
Services)
For Contract Year
20la
Drug P1i6s (n)
fAnnual Average
Effective Rate
Guarantee)
Dispensing
['ss (D)
(Annual
Average
Guarantee)
Drug Price (c)
(Annual Average
Effective Rate
Guarantee)
Dispensing
['ss (o)
[Annual
Average
Guarantee)
30 Days'Supply at a
Retail Pharmacy
AWP minus L7o/o
[Non-legend Drugs
AWP minus
16.750/o)
[Specialty Drugs:
AWP minus
16.500/o')
$1.15
AWP minus
80.250/o
[Non-legend Drugs
AWP minus
L6.75o/o)
[Specialty Drugs:
AWP minus
!6.50o/o)
$1.1s
90 Days' Supply at a
Retail Pharmacy
AWP minus22o/o
[Non-legend Drugs
AWP minus22o/o)
[Specialty Drugs:
AWP minus
1,6.500/o)
N/A
AWP minusB2o/o
(Non-legend Drugs
AWP minus22o/o)
[Specialty Drugs:
AWP minus
16.500/o)
N/A
Mail Order Pharmacy
[at 0rchard
Pharmaceutical
ServicesJ
AWP minus24o/o
(Non-legend Drugs
AWP minus24o/o)
[Specialty Drugs:
AWP minus
1,6.750/o)
N/A
AWP minusB3o/o
[Non-legend Drugs
AWP minus24o/o)
(Specialty Drugs:
AWP minus
16.75o/o)
N/A
Specialty Pharmacy
fat Orchard
Pharmaceutical
ServicesJ
(Pass-Through of Contract Rate with Dispensing PharmacyJ
(e) Calculated price using the applicable negotiated contract rate [i.e. AWP or MAC rate, or U&C Price)
for the designated Network. The AWP discounts shown in the table above are Annual Average Effective
Rates using current Medi-Span published values. If the calculated price is lower than the allowable
amount under any state Medicaid "Favored Nations" rule, Envision shall pass-through, and Plan
Sponsor shall pay, the Medicaid allowable amount.
3Glearly. Eeneficial.
16.E.1.b
Packet Pg. 2476 Attachment: 2016 Pharmacy Benefit Amendment RFP# 16-0036 (9923 : Pharmacy Benefit Amendment)
a a /\{urac} luracI\/\/L-U MirilAEF P,ri..rIY,'ENVI.rIONB.
Or
(al Annual Average Effective Rate for Brand Drugs is calculated using the actual price paid by Envision
fbefore deducting earned Manufacturer Derived Revenue) to Participating Pharmacies in the
designated Networ( plus any Cost Share, [the Ingredient Cost) for all Brand Drug Claims [including
Claims paid at the U&C Price) during a Contract Year, excluding [i) Compound Drugs; [ii) drugs
dispensed at a Specialty Pharmacy; [iii) Claims from non-Participating Pharmacies, LTC pharmacies, or
government owned or operated pharmacies [e.g. Veterans Administration); (iv) Claims paid at
government required amounts (e.g. Medicaid); [v) 340B Claims; (vi) non-Prescription Drugs; and [vii)
Claims from Plan Sponsor's owned pharmacies, if any.
(cl Annual Average Effective Rate for Generic Drugs is calculated using actual price paid by Envision to
Participating Pharmacies in the designated Networh plus any Cost Share, [the Ingredient Cost) for all
Generic Drug Claims fincluding Claims paid at the U&C Price) during a Contract Year, excluding [iJ
Compound Drugs; [ii) drugs dispensed at a Specialty Pharmacy; [iii) Claims from non-Participating
Pharmacies, LTC pharmacies, or government owned or operated pharmacies [e.g. Veterans
Administration); [iv) Claims paid at government required amounts [e.g. Medicaid); [v) 3408 C]aims;
[vi) non-Prescription Drugs; and (vii) Claims from PIan Sponsor's owned pharmacies, if any.
(o) Annual Average Dispensing Fee is the average per Claim fee for all Claims by Envision to
Participating Pharmacies in the designated Network [including Claims paid at the U&C Price) during a
Contract Year, excluding [i) Compound Drugs; (ii) drugs dispensed at a Specialty Pharmacy; (iii)
i
Claims from non-Participating Pharmacies, LTC pharmacies, or government owned or operated
pharmacies [e.g. Veterans Administration); [iv) Claims paid at government required amounts [e.g.
Medicaid); (v) non-Prescription Drugs; and (vi) Claims from Plan Sponsor's owned pharmacies, if any.
Annual Average Earned Manuf,acturer Derived Revenue GuaranteeGl,(Fl,(cl,(H)
For Contract Year 2OL7=
For 30 Day Supply of Brand Drugs at a Retail Pharmacy - $66.63 per paid Brand Drug Claiml.
o For 90 Day Supply of Brand Drugs at a Retail Pharmacy - $141,15 per paid Brand Drug Claim
o For 90 Day Supply Brand Drugs at the Mail Order Pharmacy- $202.59 per paid Brand Paid
Claim
o For a Specialty Drug at a Retail Pharmacy: $846.08 per paid Brand Drug Claim
. For a Specialty Drug at the Specialty Pharmacy: $662.25per paid Brand Drug Claim
For ContractYear ZOLBz
. For 30 Day Supply of Brand Drugs at a Retail Pharmacy - $7L.74 per paid Brand Drug Claim
o For 90 Day Supply of Brand Drugs at a Retail Pharmacy - $154.37 per paid Brand Drug Claim
o For 90 Day Supply Brand Drugs at the Mail Order Pharmacy- $219.53 per paid Brand Paid
Claim
o For a Specialty Drug at a Retail Pharmacy: $973.66 per paid Brand Drug Claim
r For a Specialty Drug at the Specialty Pharmacy: $745.03 paid Brand Drug Claim
(El Earned Manufacturer Derived Revenue guarantees are stated as annual average amounts per
Contract Year,
4Clearly. Beneficial.
16.E.1.b
Packet Pg. 2477 Attachment: 2016 Pharmacy Benefit Amendment RFP# 16-0036 (9923 : Pharmacy Benefit Amendment)
a a ,t/\{ura} luacl\/\/L-a ffiENVI/IONB.
4"
(Fl Guarantees require PIan Sponsor to maintain a Benefit Plan that has a tier structure with a minimum
$20 differential in Cost Share between preferred Brand Drugs and non-preferred Brand Drugs.
(cl 340B Claims, Claims paid entirelyby Covered Individuals, and Claims processed from Plan Sponsor's
owned pharmacies, if any, shall be excluded from the calculation of the guarantees above.
(Hl Guarantees require PIan Sponsor to utilize current Envision Select Formulary
Administrative Fee (Payable to Envision; not including fees payable to Plan Sponsor's TPAs,
consultants, or brokers, ifanyJ
For ContractYear 2OL7 & 2018: $1.85 per Claim
Fees for Additional Services and Miscellaneous Expenses
1-. Replacement by Envision of lost or stolen ID
Cards
$1.00 per card plus $0.15 per packet and
cost ofpostage
2. Manual Claims Processing fincluding DMRs)$1.50 per Claim processed
3. Claim Adjustment Checks fcharged to Plan
Sponsor for reimbursements made to Covered
Individuals for Claim adjustments requested
by Plan Sponsor.)$8.50 per check
4. Manually create or update the Eligibility File $1.00 per Covered Individual data entry
5. Ad Hoc Computer or Report Programming $150.00 per hour
6. Clinical Prior Authorizations Initial Coverage
Determinations)$3 5.00 per authorization
7. Drug Therapy Care Gap Management $0.55 per Member, per month
L Medication Adherence and Persistency (up to
three disease states)$0.55 per Member, per month
9. Additional User to Access RxBirt [beyond 1
userJ $1,200.00 per user
10. Custom Formulary Management The greater of $0.20 per Member per
month IPMPM) or $2,000.00 per month
5Glearly, Bene{icial.
\.{
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