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A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK "Agreement' means this Administrative Services Agreement between Administrator and Client, the Client Application and all other exhibits, supplements, amendments, addenda and/or schedules to this Administrative Services Agreement. "Ancillary Supplies Equipment and Services" or "ASES" means ancillary supplies, equipment, and services provided or coordinated by ESI Specialty Pharmacy in connection with ESI Specialty Pharmacy's dispensing of Specialty Products. "Average Wholesale Price" or "AWP" means the average wholesale price of a prescription drug as identified by drug pricing services such as Medi -Span, the drug manufacturer or other source recognized in the retail prescription drug industry (the "PricingSource'). If the Pricing Source discontinues the reporting of AWP or materially changes the manner in which AWP is calculated or reported, then ESI reserves the right to make an equitable adjustment as necessary to maintain the parties' relative economics and the pricing intent of this Agreement. "Brand/Generic Algorithm" or "BGA" means ESI's standard and proprietary brand/generic algorithm utilized by ESI, a copy of which may be made available for review by Client upon request; ESI may require that Client sign a non -disclosure with ESI in order to receive a copy of the BGA. The purposes of the algorithm are to stabilize products "flipping" between brand and generic status and to reduce Client, Member and provider confusion due to fluctuations in brand/generic status. Administrator or its Auditor may audit ESI's application of its BGA to confirm that ESI is making brand and generic drug determinations consistent with such algorithm. "Brand Drug" means a prescription drug identified as such in ESI's master drug file using indicators from First Databank (or other source nationally recognized in the prescription drug industry used by ESI for all clients) on the basis of a standard Brand/Generic Algorithm utilized by ESI for all of its clients, a copy of which may be made available for review by Administrator, Client, or its Auditor upon request. Notwithstanding the foregoing, certain prescription drug medications that are licensed and then currently marketed as brand name drugs, where there exists at least one (1) competing prescription medication that is a generic equivalent and interchangeable with the marketed brand name drug, may process as "Generic Drugs" for Prescription Drug Claim adjudication and Member Copayment purposes. "Business Days" or "business days" means all days except Saturdays, Sundays, and federal holidays. All references to "day(s)" are to calendar days unless `business day" is specified. "Claims Cycle" means the frequency by which Prescription Drug Claims are billed. "Claims Older than 180 DUs" means Claims that have not been submitted to ESI within 180 days of the service date of the claim. "Client Data" means Raw Data received by Administrator from Client in connection with the Services. "Contract Year" means the full twelve (12) month period commencing on the Effective Date and each full consecutive twelve (12) month period thereafter that this Agreement remains in effect. "Copayment" means that portion of the charge for each Covered Drug dispensed to the Member, that is paid by the Member (e.g., copayment, coinsurance and/or deductible). A Member's Copayment charged for a Covered Drug will be the lesser of the applicable Copayment, AWP discount (e.g. MAC price for Generic Drugs), or U&C. "Cost Share" means the amount which a Member is required to pay for a prescription or authorized refill in accordance with the Plan Design, which may be a deductible, a percentage of the prescription price, a fixed amount and/or other charge or penalty. NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL; PROPRIETARY AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS