Common use of Services to be provided by Company Clause in Contracts

Services to be provided by Company. The Company shall provide the following support for the pharmacy expense benefit provided under the Plan Sponsor’s Plan: (1) Based on the information it receives from the Plan Sponsor, timely notify PBM of the identity of each Member eligible for pharmacy expense benefits under the Plan, the date the Member becomes eligible, and the date the Member’s eligibility ends. (2) Reimburse PBM for the total of the amount of all payments due pursuant to the Drug Claims provision in this Agreement’s Section 4, “Payments to the Company,” for drugs provided to Members during the preceding billing period, including dispensing fees the PBM charged for prescriptions filled for Members by participating and mail-order pharmacies during the preceding billing period. (3) The Plan Sponsor acknowledges that the PBM’s mail service pharmacy may, from time to time, engage in therapeutic interchanges. (4) The PBM’s mail service pharmacy may dispense drugs to Members even if the prescription is not accompanied by the correct copayment, coinsurance, or deductible amount. If the Company is charged for any uncollectible copayment, coinsurance, or deductible amount, the Plan Sponsor shall be liable to Company for such amount if reasonable collection efforts by the PBM fail.

Appears in 2 contracts

Samples: Administrative Services Agreement, Stop Loss Application; Policy; And Administrative Services Agreement

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Services to be provided by Company. The Company shall provide the following support for the pharmacy expense benefit provided under the Plan Sponsor’s 's Plan: (1) Based on the information it receives from the Plan Sponsor, timely notify PBM of the identity of each Member eligible for pharmacy expense benefits under the Plan, the date the Member becomes eligible, and the date the Member’s 's eligibility ends. (2) Reimburse PBM for the total of the amount of all payments due pursuant according to the Drug Claims provision in this Agreement’s 's Section 4, "Payments to the Company," for drugs provided to Members during the preceding billing period, including dispensing fees the PBM charged for prescriptions filled for Members by participating and mail-mail- order pharmacies during the preceding prior billing period. (3) The Plan Sponsor acknowledges that the PBM’s 's mail service pharmacy may, from time to time, engage in therapeutic interchanges. (4) The PBM’s 's mail service pharmacy may dispense drugs to Members even if the prescription is not accompanied by the correct copayment, coinsurance, or deductible amount. If the Company is charged for any uncollectible copayment, coinsurance, or deductible amount, the Plan Sponsor shall be liable to the Company for such amount if reasonable collection efforts by the PBM fail.

Appears in 2 contracts

Samples: Stop Loss Application and Administrative Services Agreement, Stop Loss Application and Administrative Services Agreement

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Services to be provided by Company. The Company shall provide the following support for the pharmacy expense benefit provided under the Plan Sponsor’s 's Plan: (1) Based on the information it receives from the Plan Sponsor, timely notify PBM of the identity of each Member eligible for pharmacy expense benefits under the Plan, the date the Member becomes eligible, and the date the Member’s 's eligibility ends. (2) Reimburse PBM for the total of the amount of all payments due pursuant according to the Drug Claims provision in this Agreement’s 's Section 4, "Payments to the Company," for drugs provided to Members during the preceding billing period, including dispensing fees the PBM charged for prescriptions filled for Members by participating and mail-order pharmacies during the preceding prior billing period. (3) The Plan Sponsor acknowledges that the PBM’s 's mail service pharmacy may, from time to time, engage in therapeutic interchanges. (4) The PBM’s 's mail service pharmacy may dispense drugs to Members even if the prescription is not accompanied by the correct copayment, coinsurance, or deductible amount. If the Company is charged for any uncollectible copayment, coinsurance, or deductible amount, the Plan Sponsor shall be liable to the Company for such amount if reasonable collection efforts by the PBM fail.

Appears in 1 contract

Samples: Stop Loss Application and Administrative Services Agreement

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