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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: 92lF7A24-D5CE-4BCC-9F3C-5E7844661266 <br />Agreement shall require Administrator to periodically render an accounting to Insurer detailing all transac- <br />tions performed by Administrator pertaining to the business underwritten by Insurer. N.C. Gen. Stat. § 58- <br />56-31(a). <br />11.2 If charges deposited in a fiduciary account have been collected on behalf of or for one or <br />more insurer, Administrator shall keep records clearly recording the deposits in and withdrawals from the <br />account on behalf of each insurer. Administrator shall keep copies of all the records and, upon request of <br />Insurer, shall furnish Insurer with copies of the records pertaining to the deposits and withdrawals. N.C. <br />Gen. Stat. § 58-56-31(b). <br />11.3 Administrator shall not pay any Claim by withdrawals from a fiduciary account in which <br />or charges are deposited. Withdrawals from this account shall be made only as provided in the Agreement. <br />The Agreement shall address, but not be limited to, the following: 1) Remittance to an insurer entitled to <br />remittance; (2) Deposit in an account maintained in the name of Insurer; (3) Transfer to and deposit in a <br />Claims -paying account, with Claims to be paid as provided in subsection (d) of N.C. Gen. Stat. § 58-56- <br />31(d); (4) Payment to a group policyholder for remittance to the insurer entitled to the remittance; (5) Pay- <br />ment to Administrator of its commissions, fees, or charges; (6) Remittance of a return premium to the <br />person entitled to the return premium. N.C. Gen. Stat. § 58-56-31(c). <br />11.4 All Claims paid by Administrator from funds collected on behalf of or for Insurer shall be <br />paid only on drafts or checks of and as authorized by Insurer. N.C. Gen. Stat. § 58-56-31(d). <br />12. Compensation to Administrator. The Agreement shall not provide for commissions, fees, or <br />charges contingent upon savings obtained in the adjustment, settlement, and payment of losses covered by <br />Insurer's obligations. Administrator may receive performance-based compensation for providing auditing <br />services or may receive compensation based on charges collected or the number of Claims paid or pro- <br />cessed. N.C. Gen. Stat. § 58-56-36. <br />13. Notice to Covered Individuals. Administrator shall provide written notice approved by Insurer <br />to Eligible Persons advising them of the identity of, and relationship among, Administrator, Eligible Person, <br />and Insurer. N.C. Gen. Stat. § 58-56-41(a). If Administrator collects funds, the reason for collection of <br />each item must be identified to Eligible Persons and each item must be shown. Additional charges may <br />not be made for services to the extent the services have been paid for by Insurer. N.C. Gen. Stat. § 58-56- <br />41(b). Administrator shall disclose to Insurer all charges, fees, and commissions received from all services <br />in conjunction with the provision of administrative services for Insurer, including any fees or commissions <br />paid by insurers providing reinsurance. N.C. Gen. Stat. § 58-56-41(c). <br />145 <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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