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2025-126D
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2025-126D
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Last modified
9/16/2025 9:32:13 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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A TRUE COPY <br />CERTWICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />acknowledges and agrees that RIGHTWAY and the Participating Pharmacies may rely on the accuracy and <br />completeness of all information provided by Client, in providing Services hereunder. <br />Section 3.03. Plan Documents. Client represents that Client or the designated service provider will <br />provide RIGHTWAY with all required Plan Documents, including a current and accurate copy of the <br />summary plan description ("SPD") provided to Eligible Persons describing the terms and conditions of <br />coverage offered under the Plan, in an accurate, correct, and timely manner as required by RIGHTWAY. <br />RIGHTWAY shall use such Plan Documents information for purposes of administering the prescription <br />drug program for Client under this Agreement. Client shall provide RIGHTWAY with advance written <br />notice of any changes to the Plan and/or Plan Documents that affect the Services provided under this <br />Agreement within a reasonable period of time prior to the effective date of the change to allow RIGHTWAY <br />to determine if such change will alter the Services RIGHTWAY provides under this Agreement. Any <br />change in the Services to, be provided by RIGHTWAY under this Agreement which would be caused by <br />any such changes must be mutually agreed to in writing prior to implementation of such change. <br />RIGHTWAY will notify Client if (i) the change increases RIGHTWAY's cost of providing Services under <br />this Agreement; or (ii) RIGHTWAY is reasonably unable to implement or administer the change. The <br />parties shall negotiate in good faith any new fees that may be required to implement and/or administer the <br />Plan change. If RIGHTWAY notifies Client that RIGHTWAY is unable to reasonably implement or <br />administer the change, RIGHTWAY shall have no obligation to implement or administer the change. <br />RIGHTWAY shall not be liable for any Client caused inaccuracies and/or mistakes in the Plan Documents. <br />Section 3.04. Eligibility. Client or its designated third -party service provider will prepare, maintain, and <br />update the Eligibility File, which shall be accurate and provided to RIGHTWAY in a timely manner and in <br />a format and at a frequency mutually acceptable to both parties. RIGHTWAY shall have the right to rely <br />upon any written documented communication from Client, its designated employees, agents, or authorized <br />representatives. If Client retroactively changes an Eligible Person's status under the Plan, Client shall be <br />responsible for payment of all Claims related to such Eligible Person that are processed prior to <br />RIGHTWAY processing the notification of the retroactive eligibility. <br />Section 3.05. Eligible Person Authorizations, Consents, and Notices. Client represents and warrants <br />that it has or shall obtain the Eligible Persons' consents and/or authorizations required, if any, for <br />RIGHTWAY to provide the Services and for the use and disclosure of information, including PHI, as <br />permitted under this Agreement. Client will provide Eligible Persons the information and documents they <br />need to obtain benefits under the Plan within a reasonable period of time before coverage begins. In the <br />event this Agreement is terminated, Client will notify all Eligible Persons that the Services RIGHTWAY <br />is providing under this Agreement are discontinued. <br />Section 3.06. Client's Authority Over Plans. RIGHTWAY is not the Plan Administrator of the Plan. <br />Any references in this Agreement to RIGHTWAY "administering the Plan" are descriptive only and do not <br />confer upon RIGHTWAY other than certain agreed upon claim administration duties. Client accepts total <br />responsibility for the Plan for purposes of this Agreement including its benefit design, the legal sufficiency <br />and distribution of SPDs, and compliance with any Laws that apply to Client or the Plan, whether or not <br />Client or someone Client designates is the Plan Administrator. Unless otherwise stated in this Agreement, <br />Client and/or Plan Administrator, or its delegate (excluding RIGHTWAY) retain the sole and absolute <br />authority to design, amend, terminate, or modify, in whole or in part, all or any portion of the Plan, including <br />the sole authority to control and administer the Plan and any assets of the Plan. Client and/or Plan <br />Administrator, or its delegate (excluding RIGHTWAY) shall also have complete discretionary, binding, <br />and final authority to construe the terms of the Plan, to interpret ambiguous Plan language, to make factual <br />determinations regarding the payment of Claims or provision of benefits and to review denied Claims and <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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