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. Disclosures Service Description of Disclosures Medical Administration All our Administration Fees are NET of broker commission. Run-out Processing is subject to 3 months of base administrative fee charged by line of coverage. Any changes to the Plan’s benefit design and/or Plan Administration must be communicated by the Plan Sponsor to us a minimum of sixty (60) days prior to renewal. We reserve the right to pass through any and all regulatory assessments, fees, or similar financial obligations that are attributable to a client health plan whether known or not during the sales process or that may become applicable during the term of our services to a client and its health plan. We shall use reasonable efforts to identify and communicate to clients about assessments that it will be liable for, but shall bear no liability for such obligations. We reserve the right to re-rate services based on the complexity of the Plan’s benefit design, and in the event Plan enrollment deviates +/-10% from the covered lives at the point renewal was issued. Pharmacy Benefit Manager (PBM) We are integrated with three Preferred PBMs and work closely with their teams to manage client and member satisfaction as well reporting and rebate distribution (as applicable). Clients selecting one our three preferred PBMs must sign a participating group/sponsor agreement with the PBM to agreeing to fund claims. We require at least 100 day’s prior written notice prior to the end of your then current initial or renewal term. A run-out terms agreement will be required to terminate a preferred PBM agreement. Termination for convenience outside of the end current term is not allowed. As part of our arrangements with our preferred CVS and MagellanRx PBMs, we receive compensation on certain claims processed under the client’s Rx benefits. Clients selecting our CVS or MagellanRx PBM contract qualify for an administrative credit. On our CVS Caremark contract there is a discount of $2.00 PEPM, on our MagellanRx contract there is a discount of $2.00 or $3,00 PEPM, as determined by the contract, we apply credits to the base medical administration fees. For clients selecting our preferred Prescryptive contract, we receive compensation in the form of a partial retention of the PEPM fee. Additional approved PBM’s where we accommodate eligibility and accumulator file feeds only, include Costco Health Solutions, Navitus Health Solutions, Express Scripts, MaxorPlus, Elixir Pharmacy, RxBenefits, NW Pharmacy Services, OptumRx, WellDyneRx, SAV-RX and SmithRx. We reserve the right to charge set up fees associated with a new approved PBM. Non-PBM Buy up products Most of our buy-up products will require accompanying SPD language updates that our team will provide as an amendment. Clients opting into our non-PBM buy-up products agree to provide at least 60 day’s termination notice for each product should client choose to terminate on not renew elected buy-up products. For products with claims-based billing, runout terms apply. Mid-term termination for convenience may be prohibited on select products. 35 Please Note: the content in this and the accompanying Client Insights document is intended to be informational only and cannot be relied upon as legal advice. The Plan Sponsor is ultimately responsible for the compliance of the Plan design and t he benefits offered.