Delegation of Responsibilities Agreement Sample Contracts

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AGREEMENT FOR DELEGATION OF RESPONSIBILITIES Alliance Health TO
Delegation of Responsibilities Agreement • November 12th, 2019

This Delegation of Responsibilities Agreement (the “Agreement”), effective as of the ___ day of ______, 2020, by and between Alliance Health (“The Plan” or “Alliance”) sets forth the terms and conditions under which The Plan, in accordance with the requirements of the NCQA, shall delegate to ______________________ (referred to herein as “Delegate”) specific PBM activities. All capitalized terms used but not defined herein shall have the meanings ascribed to them in the PBM Services Agreement (the “PBM Services Agreement”) dated _______________________, as amended, by and among the parties.

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