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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />(a) Exclusive Specialty. For Exclusive Specialty arrangements, the specialty guarantee shall only apply <br />to Plans for which the ESI Specialty Pharmacy is the exclusive pharmacy that may fill Specialty <br />Products for Members, other than Exclusive or Limited Distribution Products not available at the ESI <br />Specialty Pharmacy. Any Specialty Product dispensed at a Participating Pharmacy (for example, <br />Limited Distribution Products not then available through ESI Specialty Pharmacy or overrides) will <br />be reimbursed at the standard Participating Pharmacy Specialty Product rates shown below. Upon <br />ESI Specialty Pharmacy acquisition of Exclusive or Limited Distribution Products, Members will <br />obtain prescriptions through ESI Specialty Pharmacy. <br />(b) Precision Specialty. In situations where regulations prevent implementation of Exclusive Specialty <br />arrangements, Client 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) Dispensing 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 not 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 the <br />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, or <br />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- 19.5% <br />Open Specialty Arrangements <br />Average Annual Ingredient Cost Guarantee: <br />Limited Distribution Claims (does not apply to <br />AWP — 15.25% <br />gene thera <br />(e) Exclusions. In addition to the general exclusions identified above in Sections C.3.1(a), (b) <br />("Prescription Drug Claims Excluded"), all non -Specialty Products and all Exclusive or Limited <br />Distribution Products (except for the Limited Distribution guarantee noted in the chart above) are <br />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 />12 <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />