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NAICS Code· 524292

NAICS 524292: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

This U.S. industry comprises establishments primarily engaged in providing pharmacy benefit management (PBM) services and other third party administration services of insurance and pension funds, such as claims processing and other administrative services to insurance carriers, employee benefit plans, and self-insurance funds. Cross-References. Establishments primarily engaged in--Show more

NAICS 524292 — Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds — encompasses the administration of complex health benefit programs, including pharmacy claims processing, formulary management, prior authorization, drug utilization review, and rebate negotiation for public health plans. It also covers third-party administration of pension and insurance funds, including enrollment management, benefit calculation, payment processing, and compliance reporting under federal statutes such as ERISA and the Affordable Care Act.

41
Active Contracts
$539.0M
Total Obligations (12mo)
110
Awarded Contracts (12mo)
27
Contractors Awarded (12mo)
1
Median Bidders per Award
-32.5%
YoY Growth

Contract Opportunities

Active solicitations and awarded contracts classified under NAICS 524292Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds.

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NAICS 524292 FAQ

Frequently Asked Questions

NAICS code 524292 covers Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. This U.S. industry comprises establishments primarily engaged in providing pharmacy benefit management (PBM) services and other third party administration services of insurance and pension funds, such as claims processing and other administrative services to insurance carriers, employee benefit plans, and self-insurance funds. Cross-References. Establishments primarily engaged in--

Recently Posted in Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

NAICS: 524292
SLED
DENTAL INSURANCE ASO PROGRAM
Solicitation # RFP 27-26
The City of Charlottesville is soliciting proposals for a Dental Insurance Administrative Services Only (ASO) Program through RFP 27-26. The contract aims to support a self-funded dental plan for approximately 1,100 active, benefits-eligible employees and 500 retirees. While the City currently maintains a single dental plan, it is considering a dual-option offering that includes a new buy-up plan effective July 1, 2027. The initial contract term is scheduled to run from January 4, 2027, through June 30, 2028, with the possibility of up to six additional one-year renewal terms. Based on historical billed charges from the 2025-2026 period, the estimated contract value is approximately $1,653,140. Offerors must provide pricing on a per employee per month (PEPM) basis, with rates guaranteed for a 24-month period. Proposals are evaluated based on several critical factors, including network access via GeoAccess reports, provider disruption analysis, and financial competitiveness regarding ASO fees and shared savings. The City requires strict adherence to data privacy standards for personally identifiable information and mandates that all insurance policies be issued by companies with an A.M. Best Financial Strength Rating of A- or better and a Financial Size Category of VII or higher. Additionally, the contractor must comply with various non-discrimination laws and accessibility requirements, ensuring all digital reports are compatible with screen readers. Proposals must be submitted via the OpenGov portal by the deadline of September 16, 2026.
Human Resources

POSTED

9 days ago

DEADLINE

in 19 days
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NAICS: 524292
SLED
MEDICAL PLAN ADMINISTRATION
Solicitation # RFP 27-24
The City of Charlottesville is soliciting proposals for medical plan administration services through RFP 27-24 to support approximately 1,100 active, benefits-eligible employees and 90 pre-65 retirees. The scope of work involves administering current point of service (POS) and health maintenance organization (HMO) plans, which are currently coupled with a health reimbursement arrangement (HRA). The City is also considering the addition of a high-deductible health plan (HDHP) to the mix, requiring bidders to address potential impacts on administration fees and provide comprehensive strategies for health savings account (HSA) administration and pricing. Key service requirements include high standards for claims adjudication accuracy and turnaround times, integration with a carve-out pharmacy benefit manager (PBM) featuring real-time deductible accumulators, and the provision of clinical and wellness programs such as telemedicine, tobacco cessation, and musculoskeletal support. The proposed contract term begins January 4, 2027, and runs through June 30, 2028, with options for up to six additional one-year renewals. Pricing is based on an Administrative Services Only (ASO) model, requiring detailed fee structures for base administration, claim fiduciary services, data warehouse integration, and various clinical programs. Bidders must demonstrate capabilities in advanced reporting, including on-demand financial and utilization data, and must comply with various regulatory standards such as the Consolidated Appropriations Act (CAA) and the Affordable Care Act (ACA). The solicitation requires detailed responses regarding geographic provider access and includes strict provisions for audit rights, insurance requirements, and nondiscrimination. Proposals are due by September 16, 2026.
Human Resources

POSTED

9 days ago

DEADLINE

in 19 days
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NAICS: 524292
SLED
PHARMACY BENEFITS MANAGER
Solicitation # RFP 27-25
The City of Charlottesville is soliciting proposals for Pharmacy Benefit Management (PBM) services through RFP 27-25 to support approximately 1,100 active, benefits-eligible employees and roughly 90 pre-65 retirees. The selected contractor will provide pharmacy benefits coordination for a population currently utilizing medical plan options including Point of Service (POS) and Health Maintenance Organization (HMO) plans, with a potential addition of a High-Deductible Health Plan (HDHP). A critical requirement for offerors is the ability to coordinate seamlessly with the selected medical Third Party Administrator (TPA) regarding accumulator integration, eligibility exchange, claims data, and reporting. The City is specifically requesting Traditional and Transparent (Pass-Through) arrangements, with vendor pricing guaranteed for a three-year term. The initial contract term is scheduled to run from January 4, 2027, through June 30, 2028, with the possibility of up to six additional one-year renewal terms. Key deliverables include specialty and limited distribution drug lists at the NDC level, implementation and ongoing performance guarantees, and a menu of clinical programs with associated fees. The contract is governed by the laws of the Commonwealth of Virginia and the Code of the City of Charlottesville. Offerors must comply with various regulatory and administrative standards, including the protection of personally identifiable information (PII), ADA-compliant reporting, and drug-free workplace requirements. Proposals are due by September 16, 2026, and will be evaluated with the assistance of Alliant Employee Benefits.
Human Resources

POSTED

9 days ago

DEADLINE

in 19 days
View Details

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