Healthcare Management Administrators (HMA) 2/20/2025

Proving What’s Possible in Healthcare This document contains important terms and conditions which are incorporated by reference into and becomes part of the terms of your contract with us. ©2024, Healthcare Management Administrators, Inc. 2025 additional pricing, terms and conditions •CVS Caremark shall make available to us information reflecting the amount of payments that have become due with respect to each Participating Group. •If any payment required by the Participating Group is not received by CVS Caremark in the manner and time frame communicated by us or otherwise set forth herein, CVS Caremark, may in accordance with the agreement with the Participating Group, charge late fees, withhold amounts from the security deposit, if any, cease or suspend performing services or otherwise terminate this Participating Group Agreement in accordance with the terms. •Participating Group shall have no right to offset from payments due hereunder disputed amounts or amounts due or allegedly due from CVS Caremark, except as approved in writing by CVS Caremark. Any sales, use or other tax assessment, including any surcharge or similar fee imposed under any applicable law on any health care provider, Plan Participant, service, supply or product provided under us and/or the Participating Group Agreement shall be the sole responsibility of the Participating Group as applicable and may be added to the invoice. •Discount and dispensing fee guarantees are based upon fully-funded Plan designs and apply to all paid Claims with the exception of the following exclusions: 340B Claims; Compound drug Claims; Paper or Member submitted Claims; Coordination of Benefits (COB) or secondary payor Claims; Claims paid at government required amounts; Vaccine and vaccine administration Claims. •Participating Pharmacy rates may vary and the amount paid by CVS Caremark to the Participating Pharmacy may not be equal to the amount billed to Administrator and CVS Caremark shall retain and not disclose to any third party, including Administrator, any difference. However, in states requiring a transparent network, the amount billed to the Administrator will be equal to the amount paid to the Participating Pharmacies and CVS Caremark will apply a $1.50 Administration Fee per retail Claim in those states. •CVS Caremark shall provide quarterly notices regarding any negative changes to the Formulary, which may include, but are not limited to, movement of a drug from a preferred to a non-preferred tier, or the addition of or removal of utilization management edits. •CVS Caremark shall use reasonable efforts to provide such notice at least sixty (60) days prior to such change. •In the event of a removal of a drug from the Formulary, CVS Caremark shall provide targeted communications to Plan Participants prior to the date of removal. •At Participating Group’s request and expense, CVS Caremark may prepare and provide non-standard management and utilization reports and ad hoc reports within an agreed upon time and format, at CVS Caremark’s prevailing rate. •CVS Caremark allows that any fees charged by CVS Caremark in association with machine readable files and/or compliance reporting, in addition to any other fees associated with mandated transparency requirements, •may be passed to Participating Groups. •Participating Group, shall provide CVS Caremark with sixty (60) days prior written notice of any proposed changes to the PDD, or other material Plan amendments that may impact prescription drug coverage under the Plan. •CVS Caremark may, but shall not be obligated to, dispense a prescription even if the prescription is not accompanied by the Cost Share. •CVS Caremark will credit any amount submitted by Plan Participant in excess of the Plan Participant’s Cost Share. •In the event a Plan Participant submits to CVS Caremark an insufficient Cost Share and the Plan Participant fails to remit the balance of the Cost Share amount to CVS Caremark within thirty (30) days of CVS Caremark’s request, then CVS Caremark shall have the right to invoice Participating Group. •Non-Specialty Claims dispensed by a CVS Specialty Pharmacy will price as a Retail Non-Specialty Claim. * Please Note: •Please see Participating Group Agreement and supplemental documents for full Terms and Conditions 25 Additional Terms and Conditions as follows are for clients on our contract and are effective January 2025 –December 2025. Pharmacy Benefits