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2025-126D
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2025-126D
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Last modified
9/18/2025 10:43:54 AM
Creation date
9/8/2025 1:42:16 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/03/2025
Control Number
2025-126D
Agenda Item Number
13.D.1.
Entity Name
Rightway Healthcare, Inc.
Subject
Pharmacy Benefit Management Services Agreement
Document Relationships
2025-126
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126A
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126B
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126C
(Cover Page)
Path:
\Official Documents\2020's\2025
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Docusign Envelope ID: 921F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />GEORGIA TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Georgia, "Administrator" shall mean <br />RIGHTWAY, and "Insurer" shall mean Client as that term is defined in the Agreement. <br />Notwithstanding anything in the Agreement to the contrary, Administrator and Insurer agree as follows: <br />1. Applicability. This Addendum is required in order to include the terms mandated by Ga. Comp. <br />R. & Regs. r. 120-249. This Addendum applies to the extent Eligible Person(s) reside in the State of <br />Georgia, Insurer is subject to the Rules of the Commissioner of Insurance in the Georgia Administrative <br />Code, such requirements are applicable to the services provided by Administrator under the Agreement, <br />and such requirements are not already addressed in the Agreement. <br />2. General. In the event of a direct conflict between this Addendum and the Agreement, the applica- <br />ble provisions of this Addendum shall control if required. Absent such direct conflict, the terms and con- <br />ditions of the Agreement shall remain in full force and effect. Capitalized terms not defined in this Adden- <br />dum shall have the same meaning as set forth in the Agreement. This Addendum may be modified from <br />time to time pursuant to the Agreement. <br />3. Written Agreement Necessary. Administrator shall retain as part of the official records of Ad- <br />ministrator and Insurer their written agreement for the duration of the agreement and five years thereafter. <br />Ga. Comp. R. & Regs. r. 120-2-49-.04 (1). <br />4. Payment. The Parties agree that Administrator does not collect charges or premiums for coverage <br />from Eligible Persons. Payment of return premiums or Claims by Insurer to Administrator, if any, shall <br />not be deemed payment to the Eligible Person or claimant until such payments are received by the Eligible <br />Person or claimant. Nothing herein shall limit any right of Insurer against Administrator resulting from its <br />failure to make payments to Insurer, Eligible Persons or claimants. Ga. Comp. R. & Regs. r. 120-249-.06, <br />.08. <br />5. Records. <br />5.1 Administrator shall maintain at its principal administrative office for the duration of the <br />Agreement and five (5) years thereafter, books and records of all transactions between it, Insurer, and Eli- <br />gible Persons. The Commissioner of Insurance of the State of Georgia shall have access to such books and <br />records for the purpose of examination, audit and inspection. Any trade secrets contained therein, including <br />but not limited to the identity and addresses of Eligible Persons, shall be confidential, except the Commis- <br />sioner may use such information in any proceedings instituted against the Administrator. Insurer shall retain <br />the right to continuing access to such books and records of Administrator sufficient to permit the Insurer to <br />fulfill all of its contractual obligations to Eligible Persons, subject to any restrictions in the Agreement on <br />the proprietary rights of the Parties in such books and records. Ga. Comp. R. & Regs. r. 120-2-49-.05(1). <br />5.2 Administrator shall maintain detailed books and records that reflect all administered trans- <br />actions specifically in regard to the following (if applicable): premiums, premium taxes, agent's commis- <br />sions, administrator's fees, contributions received and deposited and Claims and authorized expenses paid. <br />The detailed preparation, journalizing, and posting of such books and records shall be made in accordance <br />with the terms and conditions of the Agreement, and, as applicable, in accordance with ERISA and to enable <br />102 <br />This document is CONFIDENTIAL AND PROPRIETARY to RIGHTWAY Healthcare, Inc. and may not be reproduced, <br />transmitted, published, or disclosed to others without the prior written authorization of RIGHTWAY Healthcare, Inc. <br />
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