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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 collection and reconciliation, as described, shall be RIGHTWAY's sole obligation with respect to remedying audit discrepancies. Section 6. Claim Processing. (a) General. RIGHTWAY will process Claims with dates of fill on or after the Effective Date, through and including Claims with dates of fill prior to the termination of this Agreement. Provided that the Eligibility Files and Plan Documents information received from Client conforms with RIGHTWAY's specifications for such information and is provided at least two (2) Business Days prior to being effective, RIGHTWAY will process all Claims according to the Prescription Pricing Schedule in Exhibit 4 (Pharmacy Pricing and Rebates), Client's Eligibility Files, Plan Documents, HIPAA-required transaction code sets, in compliance with the procedures and timeframes specified under applicable U.S. Department of Labor regulations and applicable regulations under the ACA, as may be updated from time to time. RIGHTWAY shall make final decisions on Claims and appeals relating to Services under this Agreement, which decisions shall be final and binding on all Plan participants. The Plan Administrator hereby delegates to RIGHTWAY discretionary authority to determine entitlement to benefits under the Plan for each Claim and/or appeal received, including discretionary authority to interpret and construe the terms of the Plan, and RIGHTWAY agrees to undertake such duty. (b) Government Agency Submitted Claims. Government Agencies may submit Claims for, on behalf of, or in the name of Eligible Persons. RIGHTWAY will process and pay these Claims on behalf of Client consistent with the terns of this Agreement. Any amounts payable to a Government Agency will be deemed Covered Products under the Plan. Government Agencies may also submit requests for Eligible Persons lists to RIGHTWAY and, Client agrees that RIGHTWAY may submit Eligible Person information to the Government Agencies in response to such requests or allow Government Agencies to have electronic access to such lists, under a data use agreement. Eligible Person lists may include up to three (3) years of eligibility data or such longer time required by Law. Notwithstanding any other provision of this Agreement, Client acknowledges and agrees that when processing Government Agency submitted Claims, Client and Plan requirements may not apply (e.g., statutory time frames for submission of Claims may exceed Client specified time frames; days' supply limitations may not apply; Prior Authorization requirements may not apply). Client agrees that any Claims that are received after the termination or expiration of this Agreement, but filled prior to the termination or expiration, shall be processed as agreed to under this Agreement for the duration of the applicable Claims Run -Out period agreed to by the parties (as applicable) and thereafter shall be returned to the submitter with notice to submit to Client for processing. RIGHTWAY will not process Claims that predate this Agreement. In all other respects, these Claims shall be payable by Client as all other Claims are under this Agreement. (c) Direct Reimbursement Claim. Upon request, RIGHTWAY will provide an Eligible Person and Participating Pharmacies with a RIGHTWAY-approved Claim form that must be used when submitting a Direct Reimbursement Claim for Covered Products. Eligible Persons will use the form when requesting reimbursement for Covered Products provided by a Participating or Non -Participating Pharmacy. When such a Claim is submitted on the approved form, RIGHTWAY will process the Claim according to the Plan Documents and in the amount approved by the Client for payment. (d) Coordination of Benefits. RIGHTWAY's Coordination of Benefits ("COB") process manages and administers Coordination of Benefits at the point of sale as mutually agreed upon and reliant upon a COB indicator provided to RIGHTWAY by Client on the Eligibility File. 30 This document is CONFIDENTIAL AND PROPRIETARY to RIGHTWAY Healthcare, Inc. and may not be reproduced, transmitted, published, or disclosed to others without the prior written authorization of RIGHTWAY Healthcare, Inc.