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2023-032
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Last modified
2/23/2023 3:14:15 PM
Creation date
2/23/2023 3:13:35 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Addendum
Approved Date
02/07/2023
Control Number
2023-032
Agenda Item Number
8.F.
Entity Name
RxBenefits, Inc.
Subject
Addendum to Administrative Services Agreement, Removing per claim fee of
$.40 for Out of Pocket Protection + SaveOnSP Program
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r)nnnSinn Fnvelnne In, 25299Afig-A331.41R1-RFPF-COOF2A1R5AA7 <br />DocuSign Envelope ID: 4ED06744-81E1-4985-9D34-31DC21A1A620 <br />ADDENDUM TO ADMINISTRATIVE. SERVICES AGREEMENT <br />THIS ADDENDUM TO ADMINISTRATIVE SERVICES AGREEMENT (this "Addendum"), entered <br />into effective as of April I, 2022 (the "Addendum Effective Date"), is made by and between RxBenefits, Inc. <br />("Administrator") and Indian River County Board of County Commissioners ("Client"). The parties, intending to <br />be legally bound, do hereby agree as follows: <br />1. Administrator and Client are parties to that certain Addendum to Administrative Services Agreement dated <br />October 1, 2021 (the "Agreement"). <br />2. Administrator, Client, and SavcOnSP, LLC are parties to that certain SaveOnSP Services Agreement dated <br />October 1, 2019 for which Client was previously charged by Administrator $0.40 per Claim pursuant to the <br />"Manufacturer Copay Assistance Program" Section of Table 2.1 of Exhibit A to the Agreement (the "SaveOn Fees"). <br />3. Administrator and Client hereby execute this Addendum for the purpose of documenting that the SaveOn <br />Fees are hereby removed and the "Manufacturer Copay Assistance Program" Section of Table 2.1 of Exhibit A to the <br />Agreement shall be deleted and replaced with the following as of the Addendum Effective Date: <br />4. Except for the amendment of the SaveOn Fees effected hereby, the Agreement shall not otherwise be <br />modified, altered or amended in any respect. Upon execution of this Addendum by the parties' authorized <br />representatives below, this Addendum shall be in full force and effect from and after the Addendum Effective Date <br />and is hereby ratified and incorporated into the Agreement. <br />IN WITNESS WHEREOF, the undersigned parties have entered into and executed this Addendum as of <br />the Addendum Effective Date. <br />APPROVED AS TO FORM <br />AND LEGAL SUFFICIENCY <br />B <br />DYLAN REINGOLD <br />COUNTY ATTORNEY <br />Attest: Jeffrey R. Smith, Clerk of <br />Circuit Court and Comptroller <br />CLIENT: <br />Indian Rixtr County.. and <br />�p�1 ti;lSS <br />By: <br />Printed Name: Joseph H. Earman <br />• l•• �` • Qui <br />��, lj ;+ O��• <br />Its: Chairman '.,i•+•• , 1� <br />-- ,�ER COU�Zr�•; <br />Acknowledged, agreed to and accepted by: <br />ADMINISTRATOR: <br />RxBenefits, Inc. <br />By: FDocuSfgned by: <br />1,AItYt,IA, iO0,6VuS <br />Printed Name: Lauren Simmons <br />Its: Vice President of Compliance & Legal Affairs <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY, AND <br />CONSTITUTES TRADE SECRETS OF ESI AND RXRENEFITS. <br />
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