Pool Management Contract

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					              Request for Pharmacy Benefits Purchasing Pool Management and
              Pharmacy Benefits Plan Administration Services for The State of Maryland
              Solicitation No.: F10R6200071
              Revised - Addendum No. 1
              Attachment K-1: Financial Proposal Instructions - Prescription Drug Plan

              Instructions:
             A.     Complete all the attached financial exhibits for the prescription drug plan. Print your responses, and also send a
                    completed file electronically via CD. De-identified, aggregate claims and enrollment experience are provided for
                    your use in the Excel file labeled, Rx Data.xls (Excel Attachment Rx Data).
             B.     Your offer and all pricing during the term of the contract must comply with all of the following notes:
                    1. Administrative fees shown on lines 1 through 5 of Attachments K-2A1 through K-2B4 should be specific to the
                    State. Administrative fees paid by other Purchasing Pool Participants (i.e., not the State) shall be negotiated by
                    the Contractor and the Purchasing Pool Member at the time the Purchasing Pool Participant joins the Maryland Rx
                    Program.
                    2. Assumptions shown in Column A of Attachments K-2A1 through K-2B4 are provided to evaluate the impact to
                    the State of the offer provided. These assumptions are an evaluative model only and do not reflect projected
                    utilization, enrollment, or drug spend for the State Plan or any Maryland Rx Program plan. Offerors must
                    guarantee all amounts shown on each Attachment K-2A1, K-2A2, K-2A3 and K-2A4 for each corresponding
                    Maryland Rx Program enrollment tier, for each Maryland Rx Program Purchasing Pool Member, including the
                    State. The calculations for K-2B1, K-2B2, K-2B3, and K-2B4 will be performed automatically by multiplying the
                    proposed guarantee and pricing point by the assumption.
                    3. The ranking of financial proposals will be based on total cost to the State (not the cost to the Maryland Rx
                    Program as a whole) based on a weighted average of the four Purchasing Pool group proposals, as calculated in
                    Attachment K-2B Sum.
                    4. Your offer for claims processed at retail pharmacies must provide complete "pass-through" pricing for all
                    Maryland Rx Program Purchasing Pool Participants, including the State. In other words, you pass directly to the
                    State the contracts you have negotiated with retail pharmacies (i.e., you take no spread on retail claims), which
                    includes the benefit of "lowest-of-pricing logic". Example: The "lowest-of-pricing logic" means that in instances
                    where the U&C pricing is lower than the negotiated pharmacy rate and the copay, then U&C pricing will be used.
                    5. Along with "pass-through" pricing, the guarantees quoted in your financial proposal (Attachments K-2A1 through
                    K-2B4, lines 6 through 14) shall apply to each Purchasing Pool Participant on an annual basis for the duration of a
                    Purchasing Pool Participant’s participation in the Maryland Rx Program. The guarantees applicable to each
                    Purchasing Pool Participant, including the State, shall be based on the Offeror's guarantees (i.e., as shown
                    Attachment K-2A1, K2-A2, K2-A3 or K2-A4) for the enrollment tier that corresponds to the aggregate enrollment in
                    the Maryland Rx Program. The State, as a Purchasing Pool Participant, shall enjoy the benefit of these
                    guarantees with respect to the State’s Plan.
                    6. Drug ingredient cost and pricing terms, dispensing fees, and rebates for each successive enrollment tier
                    (Exhibits K-2A2 through K-2B4) must be equal to or more generous than the prior enrollment tier.
4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-1 Financial Instructions 7/5/2011    1
              Request for Pharmacy Benefits Purchasing Pool Management and
              Pharmacy Benefits Plan Administration Services for The State of Maryland
              Solicitation No.: F10R6200071
              Revised - Addendum No. 1
              Attachment K-1: Financial Proposal Instructions - Prescription Drug Plan

              Instructions:
                    7. The guarantees for each Purchasing Pool Participant may NOT require that the Purchasing Pool Participant
                    implement any plan designs or programs that are different from the plan design and programs currently in place.
                    8. The guarantees for each Purchasing Pool Participant may NOT include consideration for the following: (a)
                    claims that may be priced using a pharmacy U&C price, submitted price, etc.; (b) zero-balance claims; (c) savings
                    associated with any drug utilization review program, which includes but is not limited to switching from brands to
                    generics, etc.; (d) overages/savings from meeting guarantees for other pricing terms like rebates; etc.
                    9. For those claims that are processed at the mail and specialty pharmacies, your offer for the ingredient cost
                    component of claims costs may use discounted AWP pricing, and you are not required to pass through actual
                    acquisition pricing at mail or specialty.
                    10. For the guaranteed minimum discount percentages off AWP: The AWP must be from one nationally
                    recognized source like First DataBank, Medispan, etc. and be the one associated with the actual NDC-11
                    submitted by the pharmacy, and used to fill the prescription. Note and include separately a list of any exceptions
                    to this rule (e.g., compound prescriptions, etc.) if necessary in Attachment K-5.
                    11. In the event there are changes in the marketplace to the baseline measure used to guarantee the ingredient
                    costs of drugs (e.g. AWP), the discounts will be adjusted accordingly to provide an equivalent price. The
                    contractor has to provide notice to the State and provide a means for us to evaluate whether the effective
                    equivalent to the quoted AWP discount rate has been achieved.
                    12. The guaranteed AWP discount must be applicable to only the drug-type and place of service quoted.
                    Guarantees cannot cross drug-types and places of service to fulfill a guarantee for another drug-type at another
                    place of service.
                    13. The guaranteed average annual dispensing fee per claim that is processed at the retail pharmacies should be
                    based on paid claims, NOT claims that are reversed, rejected, etc.
                    14. The guaranteed dispensing fee per claim that is processed at the mail and specialty pharmacies, if any,
                    should be a fixed amount per paid claim. Note and include separately a list of any exceptions to this rule if
                    necessary in Attachment K-5.
                    15. Your administrative fee per Member per month (pMpm) offer should include all services listed in Attachment K-
                    3. Note and include separately a list of any exceptions to this rule if necessary in Attachment K-5.
                    "pMpm" means a cost for each Member, as defined in the State's RFP, on a monthly basis.



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-1 Financial Instructions 7/5/2011    2
              Request for Pharmacy Benefits Purchasing Pool Management and
              Pharmacy Benefits Plan Administration Services for The State of Maryland
              Solicitation No.: F10R6200071
              Revised - Addendum No. 1
              Attachment K-1: Financial Proposal Instructions - Prescription Drug Plan

              Instructions:
                    16. Provide a fixed fee per review for the Drug Utilization Review ("DUR") programs and per appeal in Attachment
                    K-2. The fee may NOT be based on the State's average membership per month or a percentage of the savings
                    realized from the program.
                    17. Provide a fixed fee for "Other Programs" in Attachment K-7 based on those programs you listed in Section
                    4.4.2.3 (Response to Scope of Work). The fee may NOT include a percentage of the savings realized from the
                    program.
                    18. "Rebates" for purposes of your offer must provide complete pass through of all revenue you receive from
                    outside sources related to each Purchasing Pool Participant's utilization or enrollment of programs, which includes
                    but is not limited to (1) access fees, market share fees, rebates, formulary access fees, administrative fees and
                    marketing grants from pharmaceutical manufacturers and wholesalers and (2) data warehouse vendors; etc.

                    19. Along with complete pass through of "rebates", you must provide a guaranteed minimum dollar amount per
                    paid prescription that each Purchasing Pool Participant will receive for "rebates." You may provide a different
                    rebate amount for prescriptions depending on the days supplied (</= 45 days and </= 90 days). The contractor
                    shall pay rebates due each Purchasing Pool Participant no less frequently than quarterly. There must be an
                    annual reconciliation between the guarantee and actual amount of rebates paid. Note and include separately a list
                    of any exceptions to this rule if necessary in Attachment K-5.
             C.     For the Attachment K-4: Financial Compliance Checklist: Please indicate your willingness to comply with
                    each requirement by placing a "Y" for yes and "N" for no in the response column of each item.
                    If you provide a "no" response, or a "yes" response with a qualifier, please provide an explanation for why you
                    cannot comply with the requirement in full in Attachment K-5 - Financial Compliance Explanation. All "No"
                    responses must have a corresponding explanation or alternative. All explanations must be numbered to
                    correspond to the questions to which they pertain and they must be brief.




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-1 Financial Instructions 7/5/2011    3
                   Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland

                   Solicitation No.: F10R6200071
                   Revised - Addendum No. 1
                   Attachment K-2A1: Guarantees for Fixed Fees, Dispensing Fees, Ingredient Cost Discounts and Rebates
                   Enrollment Tier: Less than 150,000 Members Among All Participating Pool Participants
                   Please refer to Attachment K-1 Financial Instructions when completing this attachment.
                   Financial Offer - Per Unit
                                                                                      Column A                 Column B           Column C           Column D           Column E           Column F

                                                                                    Assumptions             2007 Fiscal Year   2008 Fiscal Year   2009 Fiscal Year   2010 Fiscal Year   2011 Fiscal Year

                   ADMINISTRATIVE FEES (Dollar Amount per Unit)
                   1.   Administrative fee pMpm                                   100,000 Members
                   2.   Medicare Part D Subsidy Support Fee per month
                        per Medicare Eligible Participant Not Enrolled in
                        Part D                                                     25,000 Members
                   3.   Administrative fee per paper claim                         12,000 Paper Claims
                   4.   Fees for Drug Utilization Reviews:
                   4.a.     Prior authorizations                                    1,000   Reviews
                   4.b.     Managed Drug Limitations/Quantity Limits                2,000   Reviews
                   4.c.     Step Therapy                                            1,000   Reviews
                   4.d.     Concurrent Drug Utilization Review                  3,154,000   Reviews
                   5.   Fee per appeal                                                300   Appeals


                   DISPENSING FEES (Dollar Amount per Prescription)
                   6.   Retail
                   6.a.      Brand                                              1,740,200 Prescriptions
                   6.b.      Generic                                            1,402,650 Prescriptions
                   7.   Mail
                   7.a.      Brand                                                  1,200 Prescriptions
                   7.b.      Generic                                                  600 Prescriptions
                   8.   Specialty
                   8.a.      Brand                                                  9,400 Prescriptions
                   8.b.      Generic                                                  200 Prescriptions


                   INGREDIENT COSTS (Percent off AWP)
                   9.    Retail
                   9.a.       Brand                                          $298,625,600 Ingredient Cost
                   9.b.       Generic                                         $57,572,800 Ingredient Cost
                   10.   Mail
                   10.a.      Brand                                              $356,400 Ingredient Cost
                   10.b.      Generic                                             $43,200 Ingredient Cost
                   11.   Specialty
                   11.a.      Brand                                           $18,399,400 Ingredient Cost
                   11.b.      Generic                                            $263,000 Ingredient Cost


                   REBATES (Dollar Amount per Prescription)
                   12.   Retail
                   12.a. Guaranteed Rebate per Prescription for up to 46
                         days supply                                            2,199,995 Prescriptions
                   12.b Guaranteed Rebate per Prescription exceeding 45
                         days supply
                                                                                  942,855 Prescriptions
                   13.      Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions
                   14.      Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2A1 7/5/2011                                                           4
                  Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland
                  Solicitation No.: F10R6200071
                  Attachment K-2B1: Aggregate Costs
                  Revised - Addendum No. 1
                  Enrollment Tier: Less than 150,000 Members Among All Participating Pool Participants

                  Amounts on this attachment are calculated automatically and do not require input from the Offeror. Please see Attachment K-1 Financial Instructions for more information.


                  Financial Offer - Per Unit                                       Column A                   Column B                Column C            Column D            Column E            Column F          Column G
                                                                                  Assumptions              2007 Fiscal Year        2008 Fiscal Year    2009 Fiscal Year    2010 Fiscal Year    2011 Fiscal Year    5 Year Total

                  ADMINISTRATIVE FEES (Dollar Amount per Unit)
                  1.   Administrative fee pMpm                                   100,000 Members                              $0                  $0                 $0                  $0                  $0                   $0
                  2.   Medicare Part D Subsidy Support Fee per month
                       per Medicare Eligible Participant Not Enrolled in
                       Part D                                                     25,000 Members                              $0                  $0                 $0                  $0                  $0                   $0
                  3.   Administrative fee per paper claim                         12,000 Paper Claims                         $0                  $0                 $0                  $0                  $0                   $0
                  4.   Fees for Drug Utilization Reviews:
                  4.a.     Prior authorizations                                    1,000   Reviews                            $0                  $0                 $0                  $0                  $0                   $0
                  4.b.     Managed Drug Limitations/Quantity Limits                2,000   Reviews                            $0                  $0                 $0                  $0                  $0                   $0
                  4.c.     Step Therapy                                            1,000   Reviews                            $0                  $0                 $0                  $0                  $0                   $0
                  4.d.     Concurrent Drug Utilization Review                  3,154,000   Reviews                            $0                  $0                 $0                  $0                  $0                   $0
                  5.   Fee per appeal                                                300   Appeals                            $0                  $0                 $0                  $0                  $0                   $0


                  DISPENSING FEES (Dollar Amount per Prescription)
                  6.   Retail
                  6.a.      Brand                                              1,740,200 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0
                  6.b.      Generic                                            1,402,650 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0
                  7.   Mail
                  7.a.      Brand                                                  1,200 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0
                  7.b.      Generic                                                  600 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0
                  8.   Specialty
                  8.a.      Brand                                                  9,400 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0
                  8.b.      Generic                                                  200 Prescriptions                        $0                  $0                 $0                  $0                  $0                   $0


                  INGREDIENT COSTS (Net of % off AWP)
                  9.    Retail
                  9.a.       Brand                                          $298,625,600 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0
                  9.b.       Generic                                         $57,572,800 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0
                  10.   Mail
                  10.a.      Brand                                              $356,400 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0
                  10.b.      Generic                                             $43,200 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0
                  11.   Specialty
                  11.a.      Brand                                           $18,399,400 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0
                  11.b.      Generic                                            $263,000 Ingredient Cost                      $0                  $0                 $0                  $0                  $0                   $0


                  REBATES (Dollar Amount per Prescription)
                  12.   Retail
                  12.a. Guaranteed Rebate per Prescription for up to 46
                        days supply                                            2,199,995 Prescriptions                    $0                     $0                  $0                  $0                  $0                   $0
                  12.b Guaranteed Rebate per Prescription exceeding 45
                        days supply                                              942,855 Prescriptions                    $0                     $0                  $0                  $0                  $0                   $0
                  13.      Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions                    $0                     $0                  $0                  $0                  $0                   $0
                  14.      Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions                    $0                     $0                  $0                  $0                  $0                   $0


                  TOTAL COSTS
                  15. Administrative Fees (Lines 1 through 5)                                                              $0                     $0                  $0                  $0                  $0                   $0
                  16. Dispensing Fees (Lines 6 through 8)                                                                  $0                     $0                  $0                  $0                  $0                   $0
                  17. Ingredient Costs (Lines 9 through 11)                                                                $0                     $0                  $0                  $0                  $0                   $0
                  18. Rebates (Lines 12 through 14)                                                                       $0                     $0                  $0                  $0                  $0                   $0
                  19. Total (Lines 15 through 18)                                                                          $0                     $0                  $0                  $0                  $0                   $0



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2B1 7/5/2011                                                               5
          Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland

          Solicitation No.: F10R6200071
          Revised - Addendum No. 1
          Attachment K-2A2: Guarantees for Fixed Fees, Dispensing Fees, Ingredient Cost Discounts and Rebates
          Enrollment Tier: 150,000 to 299,999 Members Among All Participating Pool Participants
          Please refer to Attachment K-1 Financial Instructions when completing this attachment.

          Financial Offer - Per Unit
                                                                              Column A                 Column B           Column C           Column D           Column E           Column F

                                                                            Assumptions             2007 Fiscal Year   2008 Fiscal Year   2009 Fiscal Year   2010 Fiscal Year   2011 Fiscal Year

          ADMINISTRATIVE FEES (Dollar Amount per Unit)
          1.   Administrative fee pMpm                                    100,000 Members
          2.   Medicare Part D Subsidy Support Fee per month
               per Medicare Eligible Participant Not Enrolled in
               Part D                                                      25,000 Members
          3.   Administrative fee per paper claim                          12,000 Paper Claims
          4.   Fees for Drug Utilization Reviews:
          4.a.     Prior authorizations                                     1,000   Reviews
          4.b.     Managed Drug Limitations/Quantity Limits                 2,000   Reviews
          4.c.     Step Therapy                                             1,000   Reviews
          4.d.     Concurrent Drug Utilization Review                   3,154,000   Reviews
          5.   Fee per appeal                                                 300   Appeals


          DISPENSING FEES (Dollar Amount per Prescription)
          6.   Retail
          6.a.      Brand                                               1,740,200 Prescriptions
          6.b.      Generic                                             1,402,650 Prescriptions
          7.   Mail
          7.a.      Brand                                                   1,200 Prescriptions
          7.b.      Generic                                                   600 Prescriptions
          8.   Specialty
          8.a.      Brand                                                   9,400 Prescriptions
          8.b.      Generic                                                   200 Prescriptions


          INGREDIENT COSTS (Percent off AWP)
          9.    Retail
          9.a.       Brand                                           $298,625,600 Ingredient Cost
          9.b.       Generic                                          $57,572,800 Ingredient Cost
          10.   Mail
          10.a.      Brand                                               $356,400 Ingredient Cost
          10.b.      Generic                                              $43,200 Ingredient Cost
          11.   Specialty
          11.a.      Brand                                            $18,399,400 Ingredient Cost
          11.b.      Generic                                             $263,000 Ingredient Cost


          REBATES (Dollar Amount per Prescription)
          12.   Retail
          12.a. Guaranteed Rebate per Prescription for up to 46
                days supply                                             2,199,995 Prescriptions
          12.b     Guaranteed Rebate per Prescription exceeding 45
                   days supply                                            942,855 Prescriptions
          13.      Mail - Guaranteed Rebate per Prescription                1,800 Prescriptions
          14.      Specialty - Guaranteed Rebate per Prescription           9,600 Prescriptions



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2A2 7/5/2011                                                   6
                    Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland
                    Solicitation No.: F10R6200071
                    Revised - Addendum No. 1
                    Attachment K-2B2:                     Aggregate Costs
                    Enrollment Tier: 150,000 to 299,999 Members Among All Participating Pool Participants

                    Amounts on this attachment are calculated automatically and do not require input from the Offeror. Please see Attachment K-1 Financial Instructions for more information.



                    Financial Offer - Per Unit                                       Column A                   Column B             Column C            Column D            Column E            Column F          Column G
                                                                                    Assumptions              2007 Fiscal Year     2008 Fiscal Year    2009 Fiscal Year    2010 Fiscal Year    2011 Fiscal Year    5 Year Total

                    ADMINISTRATIVE FEES (Dollar Amount per Unit)
                    1.   Administrative fee pMpm                                   100,000 Members                          $0                   $0                 $0                  $0                  $0                   $0
                    2.   Medicare Part D Subsidy Support Fee per month
                         per Medicare Eligible Participant Not Enrolled in
                         Part D                                                     25,000 Members                          $0                   $0                 $0                  $0                  $0                   $0
                    3.   Administrative fee per paper claim                         12,000 Paper Claims                     $0                   $0                 $0                  $0                  $0                   $0
                    4.   Fees for Drug Utilization Reviews:
                    4.a.     Prior authorizations                                    1,000   Reviews                        $0                   $0                 $0                  $0                  $0                   $0
                    4.b.     Managed Drug Limitations/Quantity Limits                2,000   Reviews                        $0                   $0                 $0                  $0                  $0                   $0
                    4.c.     Step Therapy                                            1,000   Reviews                        $0                   $0                 $0                  $0                  $0                   $0
                    4.d.     Concurrent Drug Utilization Review                  3,154,000   Reviews                        $0                   $0                 $0                  $0                  $0                   $0
                    5.   Fee per appeal                                                300   Appeals                        $0                   $0                 $0                  $0                  $0                   $0


                    DISPENSING FEES (Dollar Amount per Prescription)
                    6.   Retail
                    6.a.      Brand                                              1,740,200 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0
                    6.b.      Generic                                            1,402,650 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0
                    7.   Mail
                    7.a.      Brand                                                  1,200 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0
                    7.b.      Generic                                                  600 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0
                    8.   Specialty
                    8.a.      Brand                                                  9,400 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0
                    8.b.      Generic                                                  200 Prescriptions                    $0                   $0                 $0                  $0                  $0                   $0


                    INGREDIENT COSTS (Percent off AWP)
                    9.    Retail
                    9.a.       Brand                                          $298,625,600 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0
                    9.b.       Generic                                         $57,572,800 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0
                    10.   Mail
                    10.a.      Brand                                              $356,400 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0
                    10.b.      Generic                                             $43,200 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0
                    11.   Specialty
                    11.a.      Brand                                           $18,399,400 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0
                    11.b.      Generic                                            $263,000 Ingredient Cost                  $0                   $0                 $0                  $0                  $0                   $0


                    REBATES (Dollar Amount per Prescription)
                    12.   Retail
                    12.a. Guaranteed Rebate per Prescription for up to 46
                          days supply                                            2,199,995 Prescriptions                    $0                  $0                  $0                  $0                  $0                   $0
                    12.b Guaranteed Rebate per Prescription exceeding 45
                          days supply                                              942,855 Prescriptions                    $0                  $0                  $0                  $0                  $0                   $0
                    13.      Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions                    $0                  $0                  $0                  $0                  $0                   $0
                    14.      Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions                    $0                  $0                  $0                  $0                  $0                   $0


                    TOTAL COSTS
                    15. Administrative Fees (Lines 1 through 5)                                                              $0                  $0                  $0                  $0                  $0                   $0
                    16. Dispensing Fees (Lines 6 through 8)                                                                  $0                  $0                  $0                  $0                  $0                   $0
                    17. Ingredient Costs (Lines 9 through 11)                                                                $0                  $0                  $0                  $0                  $0                   $0
                    18. Rebates (Lines 12 through 14)                                                                       $0                  $0                  $0                  $0                  $0                   $0
                    19. Total (Lines 15 through 18)                                                                          $0                  $0                  $0                  $0                  $0                   $0



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2B2 7/5/2011                                                                 7
                  Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of
                  Maryland
                  Solicitation No.: F10R6200071
                  Revised - Addendum No. 1
                  Attachment K-2A3: Guarantees for Fixed Fees, Dispensing Fees, Ingredient Cost Discounts and Rebates
                  Enrollment Tier: 300,000 to 499,999 Members Among All Participating Pool Participants
                  Please refer to Attachment K-1 Financial Instructions when completing this attachment.

                  Financial Offer - Per Unit
                                                                                     Column A                    Column B         Column C           Column D           Column E           Column F

                                                                                   Assumptions              2007 Fiscal Year   2008 Fiscal Year   2009 Fiscal Year   2010 Fiscal Year   2011 Fiscal Year

                  ADMINISTRATIVE FEES (Dollar Amount per Unit)
                  1.   Administrative fee pMpm                                    100,000 Members
                  2.   Medicare Part D Subsidy Support Fee per month
                       per Medicare Eligible Participant Not Enrolled in
                       Part D                                                      25,000 Members
                  3.   Administrative fee per paper claim                          12,000 Paper Claims
                  4.   Fees for Drug Utilization Reviews:
                  4.a.     Prior authorizations                                     1,000   Reviews
                  4.b.     Managed Drug Limitations/Quantity Limits                 2,000   Reviews
                  4.c.     Step Therapy                                             1,000   Reviews
                  4.d.     Concurrent Drug Utilization Review                   3,154,000   Reviews
                  5.   Fee per appeal                                                 300   Appeals


                  DISPENSING FEES (Dollar Amount per Prescription)
                  6.   Retail
                  6.a.      Brand                                               1,740,200 Prescriptions
                  6.b.      Generic                                             1,402,650 Prescriptions
                  7.   Mail
                  7.a.      Brand                                                   1,200 Prescriptions
                  7.b.      Generic                                                   600 Prescriptions
                  8.   Specialty
                  8.a.      Brand                                                   9,400 Prescriptions
                  8.b.      Generic                                                   200 Prescriptions


                  INGREDIENT COSTS (Percent off AWP)
                  9.    Retail
                  9.a.       Brand                                           $298,625,600 Ingredient Cost
                  9.b.       Generic                                          $57,572,800 Ingredient Cost
                  10.   Mail
                  10.a.      Brand                                               $356,400 Ingredient Cost
                  10.b.      Generic                                              $43,200 Ingredient Cost
                  11.   Specialty
                  11.a.      Brand                                            $18,399,400 Ingredient Cost
                  11.b.      Generic                                             $263,000 Ingredient Cost


                  REBATES (Dollar Amount per Prescription)
                  12.   Retail
                  12.a. Guaranteed Rebate per Prescription for up to 46
                        days supply                                             2,199,995 Prescriptions
                  12.b     Guaranteed Rebate per Prescription exceeding 45
                           days supply
                                                                                  942,855 Prescriptions
                  13.      Mail - Guaranteed Rebate per Prescription                1,800 Prescriptions
                  14.      Specialty - Guaranteed Rebate per Prescription           9,600 Prescriptions



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2A3 7/5/2011                                                      8
        Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland
        Solicitation No.: F10R6200071
        Revised - Addendum No. 1
        Attachment K-2B3: Aggregate Costs - Prescription Drug Plan
        Enrollment Tier: 300,000 to 499,999 Members Among All Participating Pool Participants

        Amounts on this attachment are calculated automatically and do not require input from the Offeror. Please see Attachment K-1 Financial Instructions for more information.


        Financial Offer - Per Unit                                        Column A                   Column B             Column C                Column D            Column E            Column F          Column G
                                                                         Assumptions              2007 Fiscal Year     2008 Fiscal Year        2009 Fiscal Year    2010 Fiscal Year    2011 Fiscal Year    5 Year Total

        ADMINISTRATIVE FEES (Dollar Amount per Unit)
        1.   Administrative fee pMpm                                    100,000 Members                          $0                       $0                  $0                  $0                  $0                  $0
        2.   Medicare Part D Subsidy Support Fee per month
             per Medicare Eligible Participant Not Enrolled in
             Part D                                                      25,000 Members                          $0                       $0                  $0                  $0                  $0                  $0
        3.   Administrative fee per paper claim                          12,000 Paper Claims                     $0                       $0                  $0                  $0                  $0                  $0
        4.   Fees for Drug Utilization Reviews:
        4.a.     Prior authorizations                                     1,000   Reviews                        $0                       $0                  $0                  $0                  $0                  $0
        4.b.     Managed Drug Limitations/Quantity Limits                 2,000   Reviews                        $0                       $0                  $0                  $0                  $0                  $0
        4.c.     Step Therapy                                             1,000   Reviews                        $0                       $0                  $0                  $0                  $0                  $0
        4.d.     Concurrent Drug Utilization Review                   3,154,000   Reviews                        $0                       $0                  $0                  $0                  $0                  $0
        5.   Fee per appeal                                                 300   Appeals                        $0                       $0                  $0                  $0                  $0                  $0


        DISPENSING FEES (Dollar Amount per Prescription)
        6.   Retail
        6.a.      Brand                                               1,740,200 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0
        6.b.      Generic                                             1,402,650 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0
        7.   Mail
        7.a.      Brand                                                   1,200 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0
        7.b.      Generic                                                   600 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0
        8.   Specialty
        8.a.      Brand                                                   9,400 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0
        8.b.      Generic                                                   200 Prescriptions                    $0                       $0                  $0                  $0                  $0                  $0


        INGREDIENT COSTS (Percent off AWP)
        9.    Retail
        9.a.       Brand                                           $298,625,600 Ingredient Cost                  $0                       $0                  $0                  $0                  $0                  $0
        9.b.       Generic                                          $57,572,800 Ingredient Cost                  $0                       $0                  $0                  $0                  $0                  $0
        10.   Mail
        10.a.      Brand                                               $356,400 Ingredient Cost                  $0                       $0                  $0                  $0                  $0                  $0
        10.b.      Generic                                              $43,200 Ingredient Cost                  $0                       $0                  $0                  $0                  $0                  $0
        11.   Specialty
        11.a.      Brand                                            $18,399,400 Ingredient Cost                  $0                       $0                  $0                  $0                  $0                  $0
        11.b.      Generic                                            $263,000 Ingredient Cost                   $0                       $0                  $0                  $0                  $0                  $0


        REBATES (Dollar Amount per Prescription)
        12    Retail
        12.a. Guaranteed Rebate per Prescription for up to 46
              days supply                                             2,199,995 Prescriptions                    $0                   $0                     $0                  $0                  $0                   $0
        12.b Guaranteed Rebate per Prescription exceeding 45
              days supply                                               942,855 Prescriptions                    $0                   $0                     $0                  $0                  $0                   $0
        13.       Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions                    $0                   $0                     $0                  $0                  $0                   $0
        14.       Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions                    $0                   $0                     $0                  $0                  $0                   $0


        TOTAL COSTS
        15.  Administrative Fees (Lines 1 through 5)                                                              $0                   $0                     $0                  $0                  $0                   $0
        16.  Dispensing Fees (Lines 6 through 8)                                                                  $0                   $0                     $0                  $0                  $0                   $0
        17.  Ingredient Costs (Lines 9 through 11)                                                                $0                   $0                     $0                  $0                  $0                   $0
        18.  Rebates (Lines 12 through 14)                                                                       $0                   $0                     $0                  $0                  $0                   $0
        19.  Total (Lines 15 through 18)                                                                          $0                   $0                     $0                  $0                  $0                   $0



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2B3 7/5/2011                                                          9
                 Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of
                 Maryland
                 Solicitation No.: F10R6200071
                 Revised - Addendum No. 1
                 Attachment K-2A4: Guarantees for Fixed Fees, Dispensing Fees, Ingredient Cost Discounts and Rebates
                 Enrollment Tier: More than 500,000 Members Among All Participating Pool Participants
                 Please refer to Attachment K-1 Financial Instructions when completing this attachment.

                 Financial Offer - Per Unit
                                                                                   Column A                  Column B           Column C           Column D           Column E           Column F

                                                                                  Assumptions             2007 Fiscal Year   2008 Fiscal Year   2009 Fiscal Year   2010 Fiscal Year   2011 Fiscal Year

                 ADMINISTRATIVE FEES (Dollar Amount per Unit)
                 1.   Administrative fee pMpm                                   100,000 Members
                 2.   Medicare Part D Subsidy Support Fee per month
                      per Medicare Eligible Participant Not Enrolled in
                      Part D                                                     25,000 Members
                 3.   Administrative fee per paper claim                         12,000 Paper Claims
                 4.   Fees for Drug Utilization Reviews:
                 4.a.     Prior authorizations                                    1,000   Reviews
                 4.b.     Managed Drug Limitations/Quantity Limits                2,000   Reviews
                 4.c.     Step Therapy                                            1,000   Reviews
                 4.d.     Concurrent Drug Utilization Review                  3,154,000   Reviews
                 5.   Fee per appeal                                                300   Appeals


                 DISPENSING FEES (Dollar Amount per Prescription)
                 6.   Retail
                 6.a.      Brand                                              1,740,200 Prescriptions
                 6.b.      Generic                                            1,402,650 Prescriptions
                 7.   Mail
                 7.a.      Brand                                                  1,200 Prescriptions
                 7.b.      Generic                                                  600 Prescriptions
                 8.   Specialty
                 8.a.      Brand                                                  9,400 Prescriptions
                 8.b.      Generic                                                  200 Prescriptions


                 INGREDIENT COSTS (Percent off AWP)
                 9.    Retail
                 9.a.       Brand                                          $298,625,600 Ingredient Cost
                 9.b.       Generic                                         $57,572,800 Ingredient Cost
                 10.   Mail
                 10.a.      Brand                                              $356,400 Ingredient Cost
                 10.b.      Generic                                             $43,200 Ingredient Cost
                 11.   Specialty
                 11.a.      Brand                                           $18,399,400 Ingredient Cost
                 11.b.      Generic                                            $263,000 Ingredient Cost


                 REBATES (Dollar Amount per Prescription)
                 12.   Retail
                 12.a. Guaranteed Rebate per Prescription for up to 46
                       days supply                                            2,199,995 Prescriptions
                 12.b Guaranteed Rebate per Prescription exceeding 45
                       days supply                                              942,855 Prescriptions
                 13.      Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions
                 14.      Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2A4 7/5/2011                                                    10
 Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland
 Solicitation No.: F10R6200071
 Revised - Addendum No. 1
 Attachment K-2B4: Aggregate Costs - Prescription Drug Plan
 Enrollment Tier: More than 500,000 Members Among All Participating Pool Participants

 Amounts on this attachment are calculated automatically and do not require input from the Offeror. Please see Attachment K-1 Financial Instructions for more information.

 Financial Offer - Per Unit                                       Column A                   Column B                  Column C                 Column D                 Column E                 Column F              Column G
                                                                 Assumptions              2007 Fiscal Year          2008 Fiscal Year         2009 Fiscal Year         2010 Fiscal Year         2011 Fiscal Year        5 Year Total

 ADMINISTRATIVE FEES (Dollar Amount per Unit)
 1.   Administrative fee pMpm                                   100,000 Members                          $0                            $0                       $0                       $0                       $0                  $0
 2.   Medicare Part D Subsidy Support Fee per month
      per Medicare Eligible Participant Not Enrolled in
      Part D                                                     25,000 Members                          $0                            $0                       $0                       $0                       $0                  $0
 3.   Administrative fee per paper claim                         12,000 Paper Claims                     $0                            $0                       $0                       $0                       $0                  $0
 4.   Fees for Drug Utilization Reviews:
 4.a.     Prior authorizations                                    1,000   Reviews                        $0                            $0                       $0                       $0                       $0                  $0
 4.b.     Managed Drug Limitations/Quantity Limits                2,000   Reviews                        $0                            $0                       $0                       $0                       $0                  $0
 4.c.     Step Therapy                                            1,000   Reviews                        $0                            $0                       $0                       $0                       $0                  $0
 4.d.     Concurrent Drug Utilization Review                  3,154,000   Reviews                        $0                            $0                       $0                       $0                       $0                  $0
 5.   Fee per appeal                                                300   Appeals                        $0                            $0                       $0                       $0                       $0                  $0


 DISPENSING FEES (Dollar Amount per Prescription)
 6.   Retail
 6.a.      Brand                                              1,740,200 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0
 6.b.      Generic                                            1,402,650 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0
 7.   Mail
 7.a.      Brand                                                  1,200 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0
 7.b.      Generic                                                  600 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0
 8.   Specialty
 8.a.      Brand                                                  9,400 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0
 8.b.      Generic                                                  200 Prescriptions                    $0                            $0                       $0                       $0                       $0                  $0


 INGREDIENT COSTS (Percent off AWP)
 9.    Retail
 9.a.       Brand                                          $298,625,600 Ingredient Cost                  $0                            $0                       $0                       $0                       $0                  $0
 9.b.       Generic                                         $57,572,800 Ingredient Cost                  $0                            $0                       $0                       $0                       $0                  $0
 10.   Mail
 10.a.      Brand                                              $356,400 Ingredient Cost                  $0                            $0                       $0                       $0                       $0                  $0
 10.b.      Generic                                             $43,200 Ingredient Cost                  $0                            $0                       $0                       $0                       $0                  $0
 11.   Specialty
 11.a.      Brand                                           $18,399,400 Ingredient Cost                  $0                            $0                       $0                       $0                       $0                  $0
 11.b.      Generic                                           $263,000 Ingredient Cost                   $0                            $0                       $0                       $0                       $0                  $0


 REBATES (Dollar Amount per Prescription)
 12    Retail
 12.a. Guaranteed Rebate per Prescription for up to 46
       days supply                                            2,199,995 Prescriptions                    $0                            $0                       $0                       $0                   $0                      $0
 12.b Guaranteed Rebate per Prescription exceeding 45
       days supply                                              942,855 Prescriptions                    $0                            $0                       $0                       $0                   $0                      $0
 13.      Mail - Guaranteed Rebate per Prescription               1,800 Prescriptions                    $0                            $0                       $0                       $0                   $0                      $0
 14.      Specialty - Guaranteed Rebate per Prescription          9,600 Prescriptions                    $0                            $0                       $0                       $0                   $0                      $0


 TOTAL COSTS
 15.  Administrative Fees (Lines 1 through 5)                                                             $0                            $0                       $0                       $0                   $0                      $0
 16.  Dispensing Fees (Lines 6 through 8)                                                                 $0                            $0                       $0                       $0                   $0                      $0
 17.  Ingredient Costs (Lines 9 through 11)                                                               $0                            $0                       $0                       $0                   $0                      $0
 18.  Rebates (Lines 12 through 14)                                                                      $0                            $0                       $0                       $0                   $0                      $0
 19.  Total (Lines 15 through 18)                                                                         $0                            $0                       $0                       $0                   $0                      $0



4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2B4 7/5/2011                                                        11
Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services for The State of Maryland
Solicitation No.: F10R6200071
Revised - Addendum No. 1
Attachment K-2B Sum: Weighted Aggregate Costs - Prescription Drug Plan


Amounts on this attachment are calculated automatically and do not require input from the Offeror. Please see Attachment K-1 Financial Instructions for more
information.

The financial proposal will be a weighted average of the four Purchasing Pool group proposals. The total cost for response K-2A1 and K-2B1 will be weighted at
60% (less than 150,000 members); the total cost for response K-2A2 and K-2B2 will be weighted at 20% (150,000 to 299,999 members); the total cost for response K-
2A3 and K-2B3 will be weighted at 10% (300,000 to 499,999 members); and the total cost for response K-2A4 and K-2B4 will be weighted at 10% (more than 500,000
members).

Financial Offer - Per Unit                                                      Column B              Column C                 Column D                Column E          Column G
                                                                            (Less than 150,000
                                                                                Members)          (150,000 to 299,999)     (300,000 to 499,999)    (More than 500,000      Total

TOTAL COSTS
1.   Administrative Fees (Lines 15, Column G, K-2B1, K-2B2, K-2B3, K-2B4)                    $0                       $0                      $0                    $0
2.   Dispensing Fees (Lines 16, Column G, K-2B1, K-2B2, K-2B3, K-2B4)                        $0                       $0                      $0                    $0
3.   Ingredient Costs (Lines 17, Column G, K-2B1, K-2B2, K-2B3, K-2B4)                       $0                       $0                      $0                    $0
4.   Rebates (Lines 18, Column G, K-2B1, K-2B2, K-2B3, K-2B4)                               $0                       $0                      $0                    $0
5.   Total (Lines 19, Column G, K-2B1, K-2B2, K-2B3, K-2B4)                                  $0                       $0                      $0                    $0

Weighting                                                                          60%                   20%                      10%                     10%                      100%
6.        Weighted Value - Percentage of Line 5                                             $0                       $0                       $0                    $0                $0




   4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-2B Sum 7/5/2011                                12
   Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan
   Administration Services for The State of Maryland
  Solicitation No.: F10R6200071
  Revised - Addendum No. 1
  Attachment K-3: Administrative Fee Breakdown - Prescription Drug Plan
  Note: Offerors must include all administrative fee components in the Fixed Fees (Lines 1 - 6) shown on
  Exhibits K-2A1 - K-2A4; the following checklist should be used to document Offeror's compliance with this
  provision. Detail any negative responses in the Financial Compliance Checklist Attachment K-5.


                                                                                       Offeror's Response

                                         Administrative Fees                     Fees as a Percentage of the Total

  1. Administrative Fees
       a.     ID Card Production and Delivery
       b.     Member Enrollment Packages ("packet")
       c.     One time Installation and Set-up Charge
       d.     Network Directory Booklet Charge
       e.     Formulary Booklet Charge
       f.     Printing and Mailing Costs
       g.     Fees associated with audits
       h.     Rx Electronic Charge for On-line Adjudication
       i.     Mail Service Claims Integration
       j.     Specialty Pharmacy Claims Integration
       k.     Toll-Free Number for Participants
       l.     Toll-Free Number for Pharmacies
       m.     Toll-Free Number for Providers
       n.     Formulary Management
       o.     Standard Reporting Package
       p.     Access to Web-based Reporting
       q.     Member Online Access

4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-3 Admin Fee Breakdown 7/5/2011   13
   Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan
   Administration Services for The State of Maryland
  Solicitation No.: F10R6200071
  Revised - Addendum No. 1
  Attachment K-3: Administrative Fee Breakdown - Prescription Drug Plan
  Note: Offerors must include all administrative fee components in the Fixed Fees (Lines 1 - 6) shown on
  Exhibits K-2A1 - K-2A4; the following checklist should be used to document Offeror's compliance with this
  provision. Detail any negative responses in the Financial Compliance Checklist Attachment K-5.


       r.     Hardware/Software
       s.     Claim Forms (e.g., direct member reimbursement, home delivery
       t.     pharmacy, etc.)
              Explanation of Benefits

       u.     Coordination of Benefits
       v.     Hard copy of Formulary/Preferred Drug List
       w.     Hard copy of Retail Network listing
       x.     Customer Service
       y.     Attendance at Annual Enrollment Meetings and Benefit Fairs
       z.     Corporate and Other Overhead
       aa. Taxes
       bb. HIPAA Compliance
       cc.    Contracting
       dd. Profit

       ee. Satisfaction Survey
       ff. Vendor share of State's annual open enrollment costs
       gg. 5-10 annual Ad Hoc reporting requests
       hh. Other (please specify in K-5, Explain)
       ii.    Total                                                                 0.0000%


4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-3 Admin Fee Breakdown 7/5/2011   14
   Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan
   Administration Services for The State of Maryland
  Solicitation No.: F10R6200071
  Revised - Addendum No. 1
  Attachment K-3: Administrative Fee Breakdown - Prescription Drug Plan
  Note: Offerors must include all administrative fee components in the Fixed Fees (Lines 1 - 6) shown on
  Exhibits K-2A1 - K-2A4; the following checklist should be used to document Offeror's compliance with this
  provision. Detail any negative responses in the Financial Compliance Checklist Attachment K-5.


  Medicare Part D Subsidy Support Fee per month per Medicare Eligible
  Participant Not Enrolled in Part D (guaranteed regardless of actual                 Yes/No
  enrollment)
  2.          Medicare Part D Subsidy Support Fee
       a.     Monthly eligibility submission to CMS, and response file
              management/coordination with State and PPPs
       b.     Claim submission to CMS, regardless of frequency of submission
              selected by State or PPPs
       c.     Paper claim submission fee for Coordination of Benefits for Part D
              enrollees
       d.     Prior authorizations to categorize Part B covered drugs for exclusion
              from claim submission
       e.     Storage of data for CMS audit, and participation in CMS audits, as
              needed
       f.     Certificates of Coverage at termination of Creditable Coverage,
              including postage and mailing




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-3 Admin Fee Breakdown 7/5/2011   15
                    Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits
                    Plan Administration Services for The State of Maryland
                    Solicitation No.: F10R6200071
                    Revised - Addendum No. 1
                    Attachment K-4: Financial Compliance Checklist

                                                                                                                        Offeror's Response

                    Financial Questionnaire                                                                                 Yes or No

                    F-1 Specialty drugs processed at a retail pharmacy will be included in the guarantees for retail
                        pricing terms.
                    F-2 The pricing offered for "generics" does not exclude any generics (e.g., those generics during
                        their exclusivity period, etc.)
                    F-3 The pricing offered for "brand drugs" does not exclude any brand drugs.

                    F-4 All pMpm fees must be quoted on a fully-loaded basis, i.e., fees must include all direct and
                        indirect costs, general and administrative overhead, purchasing burden and profit. No other
                        fees or charges may be added to the contract after award, nor will the Contractor be
                        compensated on any basis other than the applicable fully loaded pMpm rate.

                    F-5 Offeror will provide underwriting and actuarial related contract services.
                    F-6 The prices and guarantees quoted in lines 6 through and including 14 of Attachments K-2A1
                        through K-2B4 are guaranteed for the State of Maryland and for each Purchasing Pool
                        Participant in the MarylandRX Program.
                    F-7 The Administrative Fees quoted in lines 1 through and including 5 of Attachments K-2A1
                        through K-2B4 are guaranteed for the length of the Contract, for the applicable fiscal year,
                        for the State of Maryland for administering the State’s self-funded prescription drug plan.

                    F-8 The Contractor agrees to count, for purposes of reaching a Maryland Rx Program enrollment
                        tier, the enrollment of a Purchasing Pool Participant that leaves the Maryland Rx Program
                        but continues to contract with the Contractor for pharmacy/prescription benefit management
                        services through the period the former Purchasing Pool Participant contracts with the
                        Contractor for such services.



                    Offeror Name:

                    Authorized Representative:
                                                                                                                        Signature and Date
                    Witness:
                                                                                                                        Signature and Date


4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-4 Financial Compliance 7/5/2011            16
                Request for Pharmacy Benefits Purchasing Pool Management and
                Pharmacy Benefits Plan Administration Services for The State of
                Maryland
                Solicitation No.: F10R6200071
                Revised - Addendum No. 1
                Attachment K-5: Financial Compliance Checklist - Explanation
               Use this worksheet to provide additional explanation that you wish to offer for any questions for which a "no" response, or a
               "yes" response with a qualifier, was given.
               Explanations must be numbered to correspond to the Financial Compliance Checklist item to which it pertains.

               Please do not exceed 1,024 characters per line; if your response is longer than 1,024 characters, use multiple lines.

               Most importantly, keep all explanations brief.


                     Section/
                    Question #                                                     Explanation




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xlsK-5 Fin Compl Explain 7/5/2011        17
                     Section/
                    Question #                                                Explanation




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xlsK-5 Fin Compl Explain 7/5/2011   18
 Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services
 for The State of Maryland
 Solicitation No.: F10R6200071
 Revised - Addendum No. 1
 Attachment K-6: Specialty Drug List Analysis
 Provide a list of drugs available at your specialty pharmacy along with the information requested below.


                  Condition                                       Product   AWP Discount   Dispensing Fee   Rebate Share




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-6 Specialty 7/5/2011              19
 Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services
 for The State of Maryland
 Solicitation No.: F10R6200071
 Revised - Addendum No. 1
 Attachment K-6: Specialty Drug List Analysis
 Provide a list of drugs available at your specialty pharmacy along with the information requested below.


                  Condition                                       Product   AWP Discount   Dispensing Fee   Rebate Share




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-6 Specialty 7/5/2011              20
 Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy Benefits Plan Administration Services
 for The State of Maryland
 Solicitation No.: F10R6200071
 Revised - Addendum No. 1
 Attachment K-6: Specialty Drug List Analysis
 Provide a list of drugs available at your specialty pharmacy along with the information requested below.


                  Condition                                       Product   AWP Discount   Dispensing Fee   Rebate Share




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-6 Specialty 7/5/2011              21
           Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy
           Benefits Plan Administration Services for The State of Maryland
           Solicitation No.: F10R6200071
           Revised - Addendum No. 1
           Attachment K-7: Other Programs
           Present in this worksheet "Other Programs" based on those programs you listed in Section 4.4.2.3 (Response to Scope of
           Work). The fee may NOT include a percentage of the savings realized from the program. Provide a description of the program,
           the cost basis such as pMpm or per occurance, and return/savings for the project. Please supply the fees to coordinate with
           other vendors (i.e. Disease Managemenmt program).


                                Program                                Description                        Cost and Return on Investment
           Fees to Coordinate with Other Vendors




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-7 Other Programs 7/5/2011      22
           Request for Pharmacy Benefits Purchasing Pool Management and Pharmacy
           Benefits Plan Administration Services for The State of Maryland
           Solicitation No.: F10R6200071
           Revised - Addendum No. 1
           Attachment K-7: Other Programs
           Present in this worksheet "Other Programs" based on those programs you listed in Section 4.4.2.3 (Response to Scope of
           Work). The fee may NOT include a percentage of the savings realized from the program. Provide a description of the program,
           the cost basis such as pMpm or per occurance, and return/savings for the project. Please supply the fees to coordinate with
           other vendors (i.e. Disease Managemenmt program).


                                Program                                Description                        Cost and Return on Investment




4d4268a7-c0e6-4690-bd29-f318f587d8a3.xls K-7 Other Programs 7/5/2011      23

				
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Description: Pool Management Contract document sample