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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 />CONNECTICUT TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Connecticut, "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 terms mandated by Connecticut <br />General Statute Sections 38a -720a et seg. This Addendum applies to the extent Eligible Person(s) reside <br />in the State of Connecticut, Insurer is an "insurer" as defined in Connecticut General Statute Section 38a- <br />720(7), such requirements are applicable to the services provided by Administrator under the Agreement, <br />and such requirements are not already addressed in the Agreement. <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. Written Agreement. The written Agreement between Administrator and Insurer shall be in place <br />before Administrator may act in the capacity of a third -party administrator to Insurer. The functions that <br />Administrator will perform on behalf Insurer, as well as the lines, classes, or types of insurance that Ad- <br />ministrator is authorized to administer, and the responsibilities of Administrator regarding the administra- <br />tion of or any standards pertaining to the business underwritten by Insurer, Covered Products, premium <br />rates, underwriting criteria or Claims payment are as stated in the written Agreement. Administrator and <br />Insurer shall each maintain the Agreement as part of their official records for a minimum of five (5) years <br />after termination of the Agreement. Conn. Gen. Stat. §§ 38a-720a(c), (d)(1)-(2). <br />4. Advertising. Administrator shall use advertising relating to the business underwritten by Insurer <br />only to the extent that the advertising has been approved in writing by Insurer before the advertising is <br />used. If Administrator intends to mention any customer or person utilizing the services of Administrator <br />in its advertising, Administrator shall obtain such customer's or person's prior written consent. Conn. Gen. <br />Stat. § 38a -720d. <br />5. Insurer Responsibilities. Insurer shall be responsible for (1) determining the Covered Products, <br />premium rates, underwriting criteria, and Claims payment procedures that apply to the lines, classes or <br />types of insurance Administrator is authorized to administer; and (2) securing reinsurance, if any. Contem- <br />poraneously with execution of the Agreement, Insurer shall provide to Administrator in writing, procedures <br />pertaining to Administrator's administration of Covered Products, premium rates, underwriting criteria and <br />Claims payment. Insurer retains responsibility for the competent administration of Insurer's Covered Prod- <br />uct and service programs. To the extent Administrator administers Covered Products for more than one <br />hundred (100) Eligible Persons on behalf of Insurer, then Insurer shall, not less than semiannually, review <br />the operations of Administrator, with at least one (1) of the semiannual reviews to be an onsite audit of <br />Administrator's operations. Conn. Gen. Stat. § 38a -720e. <br />6. Accounting and Claims Payments. <br />95 <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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