My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2025-126D
CBCC
>
Official Documents
>
2020's
>
2025
>
2025-126D
Metadata
Thumbnails
Annotations
Entry Properties
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
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
179
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />RHODE ISLAND TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Rhode Island, "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 General Laws <br />of Rhode Island Annotated Title 27-20.7 et seq. This Addendum applies to the extent Eligible Person(s) <br />reside in the State of Rhode Island, Insurer is an "insurer" as defined in General Laws of Rhode Island <br />Annotated Section 27-20.7-2(6), such requirements are applicable to the services provided by Administrator <br />under the Agreement 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 condi- <br />tions of the Agreement shall remain in full force and effect. Capitalized terms not defined in this Addendum <br />shall have the same meaning as set forth in the Agreement. This Addendum may be modified from time to <br />time pursuant to the Agreement. <br />3. Written Agreement. The Agreement between Administrator and Insurer shall be in place before <br />Administrator may act in the capacity of a third party administrator to Insurer. The Agreement shall be <br />retained as part of the official records of both Administrator and Insurer for the duration of the Agreement <br />and for five (5) years thereafter. R.I. Gen. Laws § 27-20.7-3(a). <br />4. Termination. Insurer or Administrator may, with written notice, terminate the Agreement for <br />cause as provided in the Agreement. Insurer shall fulfill any lawful obligations with respect to policies <br />affected by Agreement, regardless of any dispute between Insurer and Administrator. R.I. Gen. Laws § 27- <br />20.7-3(c). <br />5. Communications with Eligible Persons/Delivery of Materials. Any policies, certificates, book- <br />lets, termination notices or other written communications delivered by Insurer to Administrator for delivery <br />to insured parties or covered individuals shall be delivered by Administrator promptly after receipt of in- <br />structions from Insurer to deliver them. R.I. Gen. Laws § 27-20.7-11. <br />6. Advertising. Administrator may only use advertising pertaining to the business underwritten by <br />Insurer that has been approved in writing by Insurer in advance of its use. R.I. Gen. Laws § 27-20.7-6. <br />7. Responsibilities of Insurer. Insurer shall be responsible for determining the Covered Products, <br />premium rates, underwriting criteria and Claims payment procedures applicable to the coverage and for <br />securing reinsurance, if any. The Parties agree that Administrator does not provide any underwriting ser- <br />vices to Insurer. Insurer understands and agrees that all underwriting decisions pertaining to the Plan are <br />solely the responsibility of Insurer. The rules pertaining to these matters must be provided, in writing, by <br />the Insurer to Administrator. The responsibilities of Administrator as to any of these matters shall be set <br />forth in the written agreement between Administrator and Insurer. R.I. Gen. Laws § 27-20.7-7(a). It is the <br />sole responsibility of Insurer to provide for competent administration of its programs. R.I. Gen. Laws § <br />27-20.7-7(b). Insurer shall, at least semi-annually, conduct a review of the operations of Administrator. At <br />least one of these reviews shall be an on-site audit of the operations of Administrator. R.I. Gen. Laws § <br />27-20.7-7(c). <br />158 <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 />
The URL can be used to link to this page
Your browser does not support the video tag.