Syfert Injury Law Firm

Definitions.

Certificate of authority to act as administrator.

Fidelity bond.

Disclosure of ownership or affiliation.

Responsibilities of insurance company with respect to administration of coverage insured.

Agreement between administrator and insurer; required provisions; maintenance of records.

Pharmacy benefit manager transparency and accountability.

Pharmacy benefit manager prohibited practices.

Investigations and examinations of pharmacy benefit managers; expenses; penalties.

Administrator as intermediary; collections held in fiduciary capacity; establishment of account; disbursement; payments on behalf of insurer.

Maintenance of records by administrator; access; confidentiality.

Notice; statement of charge or premium for coverage.

Delivery of insurer’s written communications to policyholders.

Advertising; approval by insurer.

Adjustment or settlement of claims; compensation of administrator.

Annual financial statement and filing fee; notice of change of ownership; pharmacy benefit manager filings.

Grounds for suspension or revocation of certificate of authority.

Order of suspension or revocation of certificate of authority; notice.

Period of suspension; obligations during suspension; reinstatement.

Administrative fine in lieu of suspension or revocation.

Definition of “service company” or “service agent.”

Servicing requirements for self-insurers and multiple-employer welfare arrangements.

Application for authorization to act as service company; bond.

Requirements for retaining authorization as service company; recertification.

Withdrawal of authorization as service company.

Adoption of rules.