Laserfiche WebLink
United maintains systems for processing pharmacy claims and may receive access fees as compensation for services <br />United provides to Network Pharmacies. <br />Section A8 Pharmacy Benefit Rebates <br />Allocation and Payment of Rebates. United will negotiate with drug manufacturers for the payment of Rebates to <br />United. United will retain 100% of the Rebates paid to United and any related interest. Customer will receive the <br />administrative fee credit as outlined in the Fees Exhibit. The amount of Rebate retained depends on many factors, <br />including whether Customer has an incentive benefit design, arrangements with drug manufacturers, the volume of <br />prescription drug claims and the structure of the PDL. <br />In the event a government action or a major change in pharmaceutical industry practices eliminates or materially <br />reduces manufacturer Rebate programs, Customer's payment amount may be reduced or eliminated. In such event, <br />United shall promptly notify Customer and revise or eliminate such payment effective with the date of the reduction <br />or elimination in Rebate payments. In addition, reduction or elimination of Rebates in this event shall constitute a <br />change in the Agreement as described in the Fees Section such that United has the right to negotiate the fees with the <br />Customer for the Pharmacy Benefits Management services. Termination of pharmacy benefit services shall constitute <br />a change in the Agreement as described in the Fees Section such that United has the right to increase Customer fees <br />under this Agreement. <br />Payments to Pharmacies. In connection with prescription drug claims, there may be a timing difference between <br />when United withdraw funds from Customer claims account and when United issues payments to pharmacies and <br />other payees. United may retain interest earned on these amounts during this time. Interest is expected to be paid at <br />overnight deposit rates by United's banking institution as allowed under applicable law. <br />Customer Compliance. Customer agrees that during the term of this Agreement, neither Customer nor the Plan will <br />negotiate or arrange or contract in any way for Rebates on or the purchase of prescription drug products from any <br />manufacturer with respect to the pharmacy benefits. If you or the Plan does, United may, without limiting United's <br />right to other remedies, immediately terminate Customer and Plan's entitlement to Rebates (including forfeiture of any <br />Rebates earned but not paid) and/or terminate the pharmacy benefit services. Termination of pharmacy benefit <br />services shall constitute a change in the Agreement as described in the Fees Section such that United has the right to <br />increase the fees for medical management services under this Agreement. In addition, Customer agrees to reasonably <br />cooperate with United in order to obtain Rebates. Customer will encourage Customer Participants to use a Network <br />Pharmacy. Customer will also encourage Customer Participants to electronically access the PDL on United's website, <br />and encourage Participants to share the PDL with their physicians or refer their physicians to the PDL on United's <br />website. <br />If the City elects to make any changes that constitute a change in the Agreement as described in the Fees Section, the <br />City will issue an Authorization of Change in Services such that United has the ability to negotiate the fees with the <br />Customer for the Pharmacy Benefits Management services, a sample of which is included as Exhibit F. <br />Section A9 Health Savings Account (HSA) <br />Health Savings Account (HSA). At this time, the Customer has not made the determination to offer HSAs to its <br />Participants. In the event the Customer decides to offer this service, it will notify United of its decision and United <br />will provide Customer with an HSA in accordance with this Exhibit A, Statement of Work. The HSA is not subject to <br />ERISA, and accordingly, any provisions of this Agreement which reference ERISA or which establish upon United <br />an obligation to provide reporting or other services standardly associated with an ERISA plan shall not apply to the <br />HSA and any services relating thereto. <br />Customer acknowledges that HSAs are subject to contribution limits and other requirements imposed by the IRC and <br />associated guidance issued by the IRS /Treasury Department. Customer acknowledges and agrees that United shall <br />have no obligation to ensure compliance with any requirements or limitations pertaining to HSAs, their establishment <br />and/or use. To the extent that Customer has established contribution amounts and other HSA program requirements <br />applicable to Customer's Enrolling Employees, Customer will advise United of such requirements. <br />United will not verify that distributions from Customer's Enrolling Employees' HSAs are for qualified medical <br />expenses. <br />16 <br />