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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />Guarantee and Dispensing Fee Guarantee. RIGHTWAY's vendor may assess and retain transaction fees <br />from Participating Pharmacies. <br />AWP Discount Guarantees and Dispensing Fee Guarantees shall exclude Claims for: (i) compounds, (ii) <br />vaccines, (iii) non-diabetic OTCs, (iv) DMR/Paper, (v) Coordination of Benefit, (vi) Medicaid subrogation, <br />(vii) long-term care/home infusion, (viii) Government Agencies, (ix) non -network, (x) COVID-19 test kits <br />and antivirals, (xi) Client directed overrides, and (xii) previously paid under the medical benefit. <br />Specialty Drug AWP Discount Guarantees are applicable to Specialty Drug Claims originating at Specialty <br />Pharmacies. Specialty Drug Claims dispensed at a Retail Pharmacy will be included in the Specialty Drug <br />Claim Pricing Category as long as Client's benefit design allows for only one grace fill at a Retail Pharmacy. <br />If Client's benefit design allows for more than one grace fill then the Specialty Drug Claim may be excluded <br />from the applicable AWP Discount Guarantees and Dispensing Fee Guarantees. <br />Pricing Adiudication Logic: <br />(a) Client Payment to RIGHTWAY: All Claims will adjudicate at and Client will pay RIGHTWAY <br />(except as stated in (c) below) the lower of (i) U&C (if applicable); (ii) AWP minus the Participating <br />Pharmacy's discount rate plus Dispensing Fee; (iii) MAC (if applicable) plus Dispensing Fee; or (iv) the <br />Participating Pharmacy's submitted amount plus Dispensing Fee, in each case, less the amount of any Cost - <br />Sharing Amount payable by the Eligible Person and plus any applicable sales Taxes. <br />(b) Eligible Person Payment to Pharmacy: All Claims will adjudicate at and Eligible Person will pay <br />Participating Pharmacies (except as stated in (c) below) the lower of (i) U&C (if applicable); (ii) AWP <br />minus the Participating Pharmacy's discount rate plus Dispensing Fee; (iii) MAC (if applicable) plus <br />Dispensing Fee; (iv) the Participating Pharmacy's submitted amount plus Dispensing Fee; or (v) the <br />applicable Cost -Sharing Amount, in each case, plus any applicable sales Taxes. <br />(c) Third Party Pricing (As Applicable): As part of the point-of-sale adjudication process, <br />RIGHTWAY will send certain Claims to a third party vendor to determine if additional discount pricing <br />may apply. In the event the vendor's available discount price for a Claim is lower than an Eligible Person's <br />payment amount as determined in subsection (b) above, the Claim will adjudicate at the vendor's available <br />discount price resulting in Eligible Person paying the full Claim cost plus any applicable Taxes. <br />B. Rebate Payments and Guarantees. <br />Client will receive 100% of the Rebates on a pass-through basis per RIGHTWAY's standard turnaround <br />timeline. RIGHTWAY's payment to Client for Rebates will be on a quarterly basis and will include Client's <br />portion of any Rebates collected and validated for accuracy during the applicable calendar quarter. <br />RIGHTWAY agrees to pay Client its portion of received Rebates within ninety (90) days following the end <br />of each calendar quarter in which such amounts are received, after final audit and validation of accuracy. <br />Ninety (90) days after the close of each calendar quarter, RIGHTWAY will produce a Contract Year-to- <br />date PMPM Settlement and Quarterly Rebate report and shall pay to Client the remaining amount due which <br />is equal to the greater of: (i) Rebates collected, on a Contract Year-to-date basis, or (ii) the amount required <br />for RIGHTWAY to meet its minimum Rebate obligations under this Agreement. <br />46 <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 />