In the event a CONTRACTOR becomes, or is at risk for becoming insolvent, experiences a significant event or significant loss of PARTICIPATING PHARMACIES, or if the BOARD so directs due to a significant event as described in the BOARD may do any of the following, including any combination of the following: Terminate the CONTRACT upon any notice it deems appropriate, including no notice. Close the PHARMACY BENEFIT PROGRAM administered by the CONTRACTOR to any new enrollments for the remainder of the CONTRACT period. Take no action. The BOARD may forfeit a SUBSCRIBER'S rights to the PHARMACY BENEFIT PLAN if a PARTICIPANT fraudulently or inappropriately assigns or transfers rights to an ineligible individual(s), or aids any other person in obtaining BENEFITS to which they are not entitled, or otherwise fraudulently attempts to obtain BENEFITS. The DEPARTMENT may at any time request such documentation as it deems necessary to substantiate SUBSCRIBER or DEPENDENT eligibility. Failure to provide such documentation upon request shall result in the suspension of BENEFITS. The BOARD may initiate disenrollment efforts in situations where a PARTICIPANT has committed acts of physical or verbal abuse, or is unable to establish/maintain a satisfactory physician-patient relationship with the current or alternate primary care provider. The SUBSCRIBER'S disenrollment is effective the first of the month following completion of the grievance process and approval of the BOARD. The BOARD may limit re-enrollment options in the PHARMACY BENEFITS PROGRAM. The BOARD shall determine all policy for the PHARMACY BENEFIT PLAN. In the event that the CONTRACTOR requests, in writing, that the BOARD issue program policy determinations or operating guidelines required for proper performance of the AGREEMENT, the DEPARTMENT shall acknowledge receipt of the request in writing and respond to the request within a mutually agreed upon time frame. . 125 Eligibility 125A General For PHARMACY BENEFIT PLAN purposes, per , eligible EMPLOYEES include: General state EMPLOYEES: active state and university EMPLOYEES participating in the Wisconsin Retirement System (WRS). Elected state officials. Members or EMPLOYEES of the legislature. Any blind EMPLOYEES of the Beyond Vision (aka WISCRAFT) authorized under .
In the event a CONTRACTOR becomes, or is at risk for becoming insolvent, experiences a significant event or significant loss of PARTICIPATING PHARMACIES, or if the BOARD so directs due to a significant event as described in the BOARD may do any of the following, including any combination of the following: Terminate the CONTRACT upon any notice it deems appropriate, including no notice. Close the PHARMACY BENEFIT PROGRAM administered by the CONTRACTOR to any new enrollments for the remainder of the CONTRACT period. Take no action. The BOARD may forfeit a SUBSCRIBER'S rights to the PHARMACY BENEFIT PLAN if a PARTICIPANT fraudulently or inappropriately assigns or transfers rights to an ineligible individual(s), or aids any other person in obtaining BENEFITS to which they are not entitled, or otherwise fraudulently attempts to obtain BENEFITS. The DEPARTMENT may at any time request such documentation as it deems necessary to substantiate SUBSCRIBER or DEPENDENT eligibility. Failure to provide such documentation upon request shall result in the suspension of BENEFITS. The BOARD may initiate disenrollment efforts in situations where a PARTICIPANT has committed acts of physical or verbal abuse, or is unable to establish/maintain a satisfactory physician-patient relationship with the current or alternate primary care provider. The SUBSCRIBER'S disenrollment is effective the first of the month following completion of the grievance process and approval of the BOARD. The BOARD may limit re-enrollment options in the PHARMACY BENEFITS PROGRAM. The BOARD shall determine all policy for the PHARMACY BENEFIT PLAN. In the event that the CONTRACTOR requests, in writing, that the BOARD issue program policy determinations or operating guidelines required for proper performance of the AGREEMENT, the DEPARTMENT shall acknowledge receipt of the request in writing and respond to the request within a mutually agreed upon time frame. . 125 Eligibility 125A General For PHARMACY BENEFIT PLAN purposes, per , eligible EMPLOYEES include: General state EMPLOYEES: active state and university EMPLOYEES participating in the Wisconsin Retirement System (WRS). Elected state officials. Members or EMPLOYEES of the legislature. Any blind EMPLOYEES of the Beyond Vision (aka WISCRAFT) authorized under .
Exhibit1_PBP_Agreement_Rev.docx