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<regulation prefix="Regulation" num=".04" citation="COMAR 17.04.15.04" title_num="17" subtitle_num="04" chapter_num="15" heading="Purchasing Pool Member Responsibilities.">
  <paragraph num="A.">
    <text>Each purchasing pool member shall:</text>
    <paragraph num="(1)">
      <text>Permit the Department to have access to enrollment information (limited to participant names, Social Security numbers, enrollment tier, and plan design) for purposes of Maryland Rx Program administration, such as general reporting, auditing, and verifying eligibility of the entity as a purchasing pool member;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Pay all the costs and fees, including but not limited to claims costs, administrative fees, and dispensing fees, associated with its own prescription benefits plan administered as part of the Maryland Rx Program;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Provide enrollment and eligibility data to the contractor as necessary to administer the pharmacy or prescription benefits plan administered as part of the Maryland Rx Program;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Negotiate the administrative services to be provided in administering the purchasing pool member's prescription drug plan and the administrative fees paid by the purchasing pool member for those services, the negotiations to be with the Department's contractor, agent, or representative identified by the Department for management and administration of the Maryland Rx Program;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Commit to participating in the Maryland Rx Program for a full 12 month plan year period at a time; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Acknowledge that the purchasing pool member remains the sponsor of the entity's own prescription benefits plan for its employees and is responsible for the administration, legality, and operation of that plan.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Plan Design.</text>
    <paragraph num="(1)">
      <text>A purchasing pool member may choose a copayment structure for the plan design of the pharmacy or prescription benefits plan that it shall sponsor and administer as part of the Maryland Rx Program and is not limited by the copayment structure set by the State for the State’s prescription benefits plan operated as part of the Program.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Except as otherwise provided in this chapter, each purchasing pool member may determine the design of, and who is eligible for, coverage in its own prescription benefits plan.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A purchasing pool member shall set the fully insured equivalent premiums (including employee and employer portion as applicable) for its own self-funded plan and is not limited by premiums and employer contributions set by the State for the State's plan operated as part of the Program.</text>
  </paragraph>
  <paragraph num="D.">
    <text>A purchasing pool member may set the start and end date of its 12 month plan year. Implementation services and schedules may be negotiated between the purchasing pool member and the contractor described in Regulation .06 of this chapter.</text>
  </paragraph>
</regulation>