HomeMy WebLinkAbout~Master - Waiving Purchasing Policies and Procedures for Competitive Bidding of Professional Services for Pharmacy Benefit Manager RESOLUTION NO. 23-007
RESOLUTION WAIVING PURCHASING POLICIES AND PROCEDURES FOR
COMPETITIVE BIDDING OF PROFESSIONAL SERVICES
FOR THE CITY OF AMES,IOWA
WHEREAS,the City has contracted with Wellmark Blue Cross and Blue Shield to provide
health insurance services for many years. Included in the health insurance contract are pharmacy
benefits. These pharmacy costs are projected to increase to 22% of the overall health insurance
budget in the next fiscal year; and,
WHEREAS, within the existing contract with Wellmark, it is possible to carve out
pharmacy benefit management as a separate insurance plan. Pharmacy benefits could then be
administered by a Pharmacy Benefits Manager selected through a competitive process,who would
negotiate pricing with retailers, establish the formulary (including the "tiers" of drugs placed at
different co-pay points), and administer policies such as quantity limitations and step therapy
(requirements to try a certain number of lower cost drugs before authorizing coverage for a higher-
cost non-preferred drug); and,
WHEREAS, Arthur J. Gallagher Benefits Services (Gallagher) has worked with the City
for the last six years as its benefits consultants and has become knowledgeable about the City's
benefits plans, budget, and overall goals related to the management of benefits. Gallagher is
uniquely qualified to assist City staff in selecting a Pharmacy Benefits Manager that will offer a
high level of service to employees with minimal disruption to existing service while providing
significant cost savings; and,
WHEREAS, Gallagher has provided a proposal to the City that outlines cost and timing of
a competitive bid process to select a PBM. The proposal includes the development of the scope,
expectations for service, and detailed questions for the pharmacy benefits managers that choose to
bid. Gallagher will then work with each submission to determine overall cost, potential savings,
overall plan design, and potential disruption in service based on actual pharmacy claims data and
each submission's proposed pricing structure; and,
WHEREAS, waiving the City's Purchasing Policy to allow the City to award the contract
for the PBM selection process to Gallagher to conclude in time for a July 1, 2023, effective date,
will reduce the possibility of disruption to employees and covered family members if a new PBM
is selected.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Ames, Iowa,
that the waiver of Purchasing Policies and Procedures for competitive bidding of professional
services for Pharmacy Benefits Manager is hereby approved.
ADOPTED THIS IOth day of January, 2023.
Renee kall, City Clerk John A. Haila, Mayor
Introduced by: Beatty-Hansen
Seconded by: Corrieri
Voting aye: Beatty-Hansen, Betcher, Corrieri, Gartin, Junck, Rollins
Voting nay: None Absent: None
Resolution declared adopted and signed by the Mayor this IOth day of January, 2023.