Laserfiche WebLink
Docusign Envelope ID 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />FLORIDA TPA REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Florida, "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 by Fla. Stat. § 626.882(2) in order to include the re- <br />quirements of Fla. Stat. §§ 626.883-626.888 to the extent such requirements are not addressed in the Agree- <br />ment and such requirements are applicable to the services provided by Administrator under the Agree- <br />ment. This Addendum applies to the extent Eligible Person(s) reside in the State of Florida and Insurer is <br />an "insurer" as defined in Fla. Stat. § 626.88(5). <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. Underwriting. The Parties agree that Administrator does not provide any underwriting services <br />to Insurer. Insurer understands and agrees that all underwriting decisions pertaining to the Plan are solely <br />the responsibility of Insurer. Fla. Stat. § 626.882(2)(b). <br />4. Record Retention. <br />4.1 The Agreement. Administrator and Insurer agree to retain the Agreement and any addenda <br />or amendments thereto, including this Addendum, as part of their respective official records during the term <br />of the Agreement and for at least five (5) years thereafter. Fla. Stat. § 626.882(3). <br />4.2 Maintenance. During the term of the Agreement and for at least five (5) years thereafter, <br />Administrator shall maintain adequate books and records of all transactions among Administrator, Insurer, <br />and Eligible Persons. Such books and records shall be maintained in accordance with prudent standards of <br />insurance recordkeeping. Insurer shall maintain records in accordance with the terms and conditions of the <br />Agreement. Fla. Stat. § 626.884(1). <br />4.3 Florida Office of Insurance Regulation Access. Administrator acknowledges that Florida <br />Statute § 626.884(2) provides that "the office [of insurance regulation] shall have access to books and rec- <br />ords maintained by the administrator for the purpose of examination, audit and inspection. Information <br />contained in such books and records is confidential and exempt from the [public records disclosure law] if <br />the disclosure of such information would reveal a trade secret.... However, the office may use such infor- <br />mation in any proceeding instituted against the administrator." <br />4.4 Insurer Access. Insurer retains the right of continuing access to books and records main- <br />tained by Administrator sufficient to permit Insurer to fulfill all of its contractual obligations to Eligible <br />Persons, subject to any restrictions in the Agreement on the proprietary rights of Administrator and Insurer <br />in such books and records. Fla. Stat. § 626.884(3). <br />5. Written Notice to Eligible Persons; Advertising. <br />99 <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 />