PHARMACY BENEFIT MANAGEMENT AGREEMENT This PHARMACY BENEFIT MANAGEMENT AGREEMENT (this "Agreement") is between UNITED HEALTHCARE SERVICES, INC., on behalf of itself and its affiliates from time to time, located at 9900 Bren Road East, Minnetonka, Minnesota 55343 (hereinafter "United HealthCare"), and MERCK MEDCO MANAGED CARE, L.L.C. located at 100 Summit Avenue, Montvale, New Jersey 07645-1753 (hereinafter "PBM"). This Agreement is effective on the date the parties have each executed it (the "Effective Date"). It concerns services provided as of the "Commencement Date," as hereinafter defined. This Agreement supersedes and replaces any existing agreements between the parties related to the same subject matter. W I T N E S S E T H: WHEREAS, United HealthCare desires to contract with a pharmaceutical benefits management entity for pharmaceutical benefit management and related services that United HealthCare will make available, together with other United HealthCare services, to Health Plans, as hereinafter defined, and other non-Health Plan business (affiliated with United HealthCare or to which United HealthCare provides services) through contracts with United HealthCare; and WHEREAS, PBM provides pharmaceutical benefits management and related services and desires to contract with United HealthCare to provide such management and services. NOW, THEREFORE, in consideration of the terms and conditions set forth in this Agreement, the undersigned parties agree as follows: SECTION 1. DEFINITIONS 1.1. DEFINITIONS. In addition to the capitalized terms defined elsewhere in this Agreement, the following terms shall have the following meanings: (a) "AVERAGE WHOLESALE PRICE" or "AWP" means the average wholesale price of the Covered Prescription Drug Services dispensed, utilizing the current price list in the Blue Book and its supplements. If PBM ceases to use the Blue Book and its supplements, PBM shall use such other nationally recognized pricing source as PBM uses for all of its remaining customers; or, if PBM uses more than one source, then the source used for United HealthCare shall be the source mutually agreed to by the parties. Under the Retail Pharmacy Program, AWP is based on the package size submitted. Under the Mail Service Program, AWP is based on package sizes of 100 units or 16 oz. quantities, or smaller quantities if such quantities are not commercially available. (b) "BENEFIT CONTRACT" means a benefit plan that: (i) is sponsored, purchased, issued or administered by Payor and (ii) contains the terms and conditions of a Covered Person's coverage. A Benefit Contract is also known as a certificate of coverage, summary plan
Pharmacy Benefit Management Agreement - United HealthCare Services Inc. and Merck Medco Managed Care LLC
Was this helpful?