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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 />SOUTH DAKOTA TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of South Dakota, "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 requirements of South Dakota <br />Codified Laws § 58-29D-5 in the Agreement to the extent such requirements are applicable to the services <br />provided by Administrator under the Agreement, and such requirements are not already addressed in the <br />Agreement. This Addendum applies to the extent Eligible Person(s) reside in the State of South Dakota <br />and Insurer is an "insurer" as defined in South Dakota Codified Laws § 58-29D-3. <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. Underwriting. The Parties agree that Administrator does not provide any underwriting services <br />to Insurer. Insurer understands and agrees that all underwriting decisions pertaining to the Plan are solely <br />the responsibility of Insurer. S.D. Codified Laws § 58-2913-5. <br />4. Fiduciary Account and Payment of Claims. <br />4.1 The Parties agree that Administrator will not collect premiums or charges for insurance <br />paid by or on behalf of any Eligible Person for Insurer. Payment of return premiums or Claim payments <br />forwarded by Insurer to Administrator, if any, may not be deemed to have been paid to the Eligible Person <br />or claimant until such payments are received by the Eligible Person or claimant. Nothing in this section <br />limits any right of Insurer against Administrator resulting from the failure of Administrator to make pay- <br />ments to Insurer, Eligible Persons or claimants. S.D. Codified Laws § 58-29D-7. <br />4.2 Return of premiums received from Insurer, if any, shall be held by Administrator in a fi- <br />duciary capacity. Such funds shall be immediately remitted to the person or persons entitled to them or shall <br />be deposited promptly in a fiduciary account established and maintained by Administrator in a federally or <br />state Eligible Person financial institution. The Agreement between Administrator and Insurer provides for <br />Administrator to periodically render an accounting to Insurer detailing all transactions performed by Ad- <br />ministrator pertaining to the business underwritten by Insurer. S.D. Codified Laws § 58-2913-14. <br />4.3 If charges or premiums are deposited in a fiduciary account and have been collected on <br />behalf of or for one or more insurers, Administrator shall keep records clearly recording the deposits in and <br />withdrawals from the account on behalf of each insurer. Administrator shall keep copies of all the records <br />and, upon request of Insurer, shall furnish Insurer with copies of the records pertaining to such deposits and <br />withdrawals. S.D. Codified Laws § 58-29D-15. <br />4.4 Administrator may not pay any Claim by withdrawals from a fiduciary account in which <br />premiums or charges are deposited. Withdrawals from such account shall be made as provided in the Agree- <br />ment between Administrator and Insurer. The Agreement shall address the following: (1) Remittance to an <br />163 <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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