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DocuSign Envelope ID: 5332467E-CBEF-4C5D-860E-61E380BDAl IB <br />DocuSign Envelope ID: 151ECOCF-B55C-414F-9455-72004347A310 <br />(1/2023 Version) <br />rates shown below. Upon ESI Specialty Pharmacy acquisition of Exclusive or Limited Distribution <br />Products, Members will obtain prescriptions through ESI Specialty Pharmacy. <br />(b) Precision Specialty. In situations where regulations prevent implementation of Exclusive Specialty <br />arrangements, Plans may implement a Precision Specialty arrangement where the ESI Specialty <br />Pharmacy or a Specialty Precision Network participating retail pharmacy are the exclusive <br />pharmacies that may fill Specialty Products for Members (other than Exclusive or Limited <br />Distribution Products not available at the ESI Specialty Pharmacy or a Specialty Precision Network <br />participating retail pharmacy). <br />(c) Dispcnsinu� Fee for Specialty Products. <br />* Dispensing Fees are inclusive of shipping and handling. If carrier rates (i.e., U.S. mail and/or <br />applicable commercial courier services) increase during the Term of this Agreement, the <br />Dispensing Fee guarantees will be increased to reflect such increase(s). <br />(d) SPECIALTY NET EFFECTIVE DISCOUNT GUARANTEE Administrator guarantees the <br />overall annual net effective discount for the products listed on the Specialty Products List (excluding <br />Limited Distribution Products) pursuant to the table below. Within one hundred and eighty (180) <br />days following the end of each Contract Year, Administrator will calculate the actual net effective <br />discount for the products listed on the Specialty Products List to determine if the guarantee has been <br />met. Client will retain any amount that the actual net effective discount exceeds the guaranteed net <br />effective discount. The calculation for the actual net effective discount will be as follows: ((Total <br />Ingredient Cost for the products listed on the Specialty Products List) divided by (Total AWP for <br />the products listed on the Specialty Products List)) minus 1. This guarantee is contingent on Client's <br />participation in the National Preferred Formulary or Basic Formulary and an exclusive, precision, <br />or open specialty arrangement, as applicable. For Exclusive Specialty guarantees to be reconciled <br />annually and any shortfalls paid, Client must be enrolled in the Exclusive Specialty program for the <br />entire Contract Year. <br />Average Annual Ingredient Cost Guarantee: <br />AWP- 22.5% <br />Exclusive or Precision Specialty Arrangements <br />Average Annual Ingredient Cost Guarantee: <br />Limited Distribution Claims (does not apply to <br />AWP 15% <br />gene therapy) <br />(e) Exclusions. For Exclusive Specialty arrangements, the specialty guarantee shall only apply to Plans <br />for which the ESI Specialty Pharmacy is the exclusive pharmacy that may fill Specialty Products <br />for Members, other than Exclusive or Limited Distribution Products not available at the ESI <br />Specialty Pharmacy. In addition to the general exclusions identified above. all non -Specialty <br />Products, and all Exclusive or Limited Distribution Products (except for the Limited Distribution <br />guarantee noted in the chart above) are excluded from the specialty guarantee. Prescription Drug <br />Claims filled through in-house pharmacies that are no bill, no remit or that have not entered into an <br />ESI pharmacy network agreement are excluded from the specialty guarantee. <br />(f) Ancillary Supplies. Equipment. and Services. For Specialty Products needing an additional charge <br />to cover costs of all ASES required to administer the Specialty Products, Administrator, ESI or ESI <br />Specialty Pharmacy will bill at the following standard per diem and nursing fee rates set forth below, <br />14 <br />NOT FOR DISTRIBI1TION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />