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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: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />MAINE TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Maine, "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 Maine Re- <br />vised Statutes, Title 24-A, Chapter 18 to the extent such requirements are applicable to the services provided <br />by Administrator under the Agreement, and such requirements are not already addressed in the Agree- <br />ment. This Addendum applies to the extent Eligible Person(s) reside in the State of Maine, and to the extent <br />that Insurer is a "plan sponsor," "healthcare service plan," "health maintenance organization" or "Insurer" <br />as defined in Title 24-a of the Maine Insurance Code. <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. Advertising. Administrator may use advertising pertaining to the Plan only if that advertising has <br />been approved in advance by Insurer. 24-A Maine Rev. Stat. § 1906(5). <br />4. Communications with Eligible Persons. Any policies, certificates, booklets, termination notices, <br />or other written communications delivered by Insurer to Administrator for delivery to Eligible Persons shall <br />be delivered by Administrator promptly, after receipt of instructions from Insurer to deliver them. 24-A <br />Maine Rev. Stat. § 1906(6). <br />5. Actions of Insurer. When acting as an administrator, the acts of Administrator are deemed to be <br />the acts of Insurer. In addition to any other applicable provisions of law, Insurer is accountable and may <br />be penalized by the superintendent of the Maine Bureau of Insurance, as provided for in Title 24-A of Maine <br />Revised Statutes, for the actions of its administrators. 24-A Maine Rev. Stat. § 1906(10)-(11). <br />6. Record Retention. <br />6.1 The Agreement. Administrator and Insurer agree to retain the Agreement and any addenda <br />or amendments thereto, including this Addendum, as part of their respective official records during the term <br />of the Agreement and for at least seven (7) years thereafter. 24-A Maine Rev. Stat. § 1906(2). <br />6.2 Maintenance. During the term of the Agreement and for at least seven (7) years thereafter, <br />Administrator shall maintain adequate books and records of all transactions involving Insurer and Eligible <br />Persons. Such books and records shall be maintained in accordance with generally accepted standards of <br />business recordkeeping. Administrator shall not be required to maintain copies of books and records if the <br />originals are returned to Insurer before the end of the 7 -year period. Administrator shall maintain evidence <br />of the return of the originals for the balance of the 7 -year period. 24-A Maine Rev. Stat. § 1906(3). <br />6.3 Maine Insurance Commissioner Access. Administrator acknowledges that 24-A Maine <br />Revised Statutes § 1906(9) provides that "Upon request of the superintendent, an administrator shall make <br />124 <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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