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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
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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: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />keep records clearly recording the deposits in and withdrawals from such account on behalf of or for each <br />insurer and for each self insurer. Administrator shall promptly obtain and keep copies of all such records <br />and, upon request of Insurer, shall furnish Insurer with copies of such records pertaining to deposits and <br />withdrawals on behalf of or for Insurer. Administrator shall not pay any Claim by withdrawals from such <br />fiduciary account. Withdrawals from such account shall be made, as provided in the Agreement, for (a) <br />Remittance to an Insurer; (b) Deposit in an account maintained in the name of Insurer; (c) Transfer to and <br />deposit in a Claims paying account, with Claims to be paid as provided in 120-2119-.09; (d) Payment to a <br />group policyholder for remittance to the insurer or self -insurer entitled thereto; (e) Payment to Administra- <br />tor of its fees or charges; or (f) Remittance of return premiums to the person or persons entitled thereto. Ga. <br />Comp. R. & Regs. R. 120-249-.08. <br />7. Approval of Advertising. <br />7.1 Administrator may use only such advertising pertaining to the business underwritten by <br />Insurer and approved in advance of its use. Ga. Comp. R. & Regs. r. 120-249-.13(1). <br />7.2 Administrator shall maintain at its principal administrative office a complete file of all <br />advertisements, regardless of by whom written, created or designed, which are used in the course of Ad- <br />ministrator's business in this state, with a notation indicating the manner and extent of distribution and the <br />form number of any policy advertised. Such file shall be subject to inspection by the Office of Commis- <br />sioner of Insurance. All such advertisements shall be maintained in said file for a period of not less than <br />five (5) years. Ga. Comp. R. & Regs. r. 120-249-.13(2). <br />7.3 Administrator shall file with the Commissioner of Insurance on or before March 1 in each <br />year, a certification executed by an authorized officer of the Administrator, attesting that to the best of his <br />or her knowledge, information and belief, the advertisements disseminated by Administrator during the <br />preceding calendar year complied, or were made to comply in all respects, with the advertising regulations <br />of this state. Ga. Comp. R. & Regs. r. 120-2-49-.13(3). <br />8. Notification Required. Administrator shall provide a written notice approved by Insurer, to Eli- <br />gible Persons, advising them of the identity of and relationship among Administrator and the In- <br />surer. Where Administrator collects funds, it must identify and state separately in writing to the person <br />paying to the Administrator any charge, the amount of any such charge specified by Insurer. Ga. Comp. R. <br />& Regs. r. 120-249-.15(1). <br />9. Claims Payments. All Claims paid by Administrator from funds collected on behalf of the Insurer <br />shall be paid by check, drafts, electronic funds transfer, or other method of electronic payment, as author- <br />ized by the Insurer: provided, however, the payee may elect to receive payment by check. Ga. Comp. R. & <br />Regs. r. 120-2-49-.09. <br />10. Compensation to Administrator. <br />10.1 Compensation to Administrator for any policies in which it adjusts or settles Claims shall <br />in no way be contingent on Claims experience. This section does not prevent the compensation of Admin- <br />istrator from being based on premiums or charges collected or the number of Claims paid or processed. Ga. <br />Comp. R. & Regs. r. 120-2-49-.10(1). <br />104 <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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