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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 />Minimum Rebate Guarantee means the total minimum Rebates guaranteed to Client for Covered Products <br />on the Formulary as measured, reported, and reconciled in accordance with Exhibit 4 (Pharmacy Pricing <br />and Rebates). <br />Non -Participating Pharmacy means a pharmacy that does not have an agreement with RIGHTWAY to <br />dispense Covered Products to the Eligible Persons receiving benefits under this Agreement. <br />Paid Claim means a Claim that meets coverage requirements under the Plan Document and is payable or <br />subsequently paid, net of any adjustments. Paid Claims do not include any reversed Claims, duplicate <br />Claims, or rejected Claims. <br />Participating Pharmacy means a pharmacy, or a company authorized to represent one or more subsidiary, <br />affiliated, or franchised pharmacies, which has entered into an agreement with RIGHTWAY to dispense <br />Covered Products. For purposes of this Agreement, a "Participating Pharmacy" will not be considered a <br />representative, subcontractor, or agent of RIGHTWAY and will include the Mail Service Pharmacy and the <br />Specialty Pharmacy. <br />Pass -Through means that the price that RIGHTWAY pays Participating Pharmacies for dispensing a <br />Covered Product to an Eligible Person is equal to the amount that RIGHTWAY invoices Client for a <br />Covered Product; and Rebates are provided to Client in accordance with Article IV, and RIGHTWAY does <br />not retain any Rebates or any other direct financial benefits from drug manufacturers or pharmacies and <br />pays all such amounts it receives to Client. <br />Plan means Client's self-funded plan, which provides pharmacy benefits to Eligible Persons, but only with <br />respect to those provisions of the plan relating to the self-funded health benefits RIGHTWAY is <br />administering. <br />Plan Administrator means the current or succeeding person, committee, partnership, or other entity <br />designated the Plan Administrator by Client and who is generally responsible for the Plan's operations. <br />Plan Documents means a description of Client's Plan related to pharmacy benefits and limitations thereto, <br />including the framework of policies, interpretations, rules, practices and procedures applicable to such <br />benefits, required and signed by Client and submitted to RIGHTWAY in a mutually approved format. The <br />Plan Documents shall not include any amendments except as provided in Section 3.03 (Plan Documents) <br />of this Agreement. <br />Practitioner means a physician or other health care provider authorized to prescribe medication to Eligible <br />Persons. <br />Pricing Category means each AWP Discount Guarantee, Dispensing Fee Guarantee, and Minimum Rebate <br />Guarantee included in Exhibit 4 (Pharmacy Pricing and Rebates). <br />Pricing Source means Medi -Span (or other nationally recognized third -party pricing source utilized by <br />RIGHTWAY). RIGHTWAY shall not utilize more than one Pricing Source and shall use the same updated <br />national drug file for invoicing Client and for paying Participating Pharmacies and for providing all Services <br />hereunder. <br />25 <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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