SERVICE AGREEMENT TO
REVIEW AND REOPEN
MEDICARE PART D SUBSIDY SERVICES
This AGREEMENT FOR MEDICARE PART D SUBSIDY SERVICES (this “Agreement” is
entered into by and between Part D Advisors, Inc., a Michigan corporation (hereinafter referred to as
“PDA”) and the City of Nashua (hereinafter referred to as “Plan Sponsor’) on behalf of itself and
the City of Nashua Health Plan (hereinafter referred to as the “Plan’”) and shall be effective as of
April 7.2017 (the “Effective Date”).
RECITALS
WHEREAS, Plan Sponsor maintains a group health program (hereinafter referred to as the “Plan”),
under which eligible individuals, including Retired Medicare Eligible Individuals, are able to obtain
certain prescription drug benefits; and
WHEREAS, the Plan Sponsor has filed one or more Subsidy Applications for the Plan with the
Center for Medicare and Medicaid Services (“CMS”) with respect to the Medicare Part D
Prescription Drug Program (the “Part D Program’) to receive the Medicare Drug Subsidy provided
for in the Medicare Modernization Act of 2003 and as more fully described in 42 CFR 423.880
through 888 (“Medicare Drug Subsidy”);
WHEREAS, the Plan Sponsor has one or more Subsidy Application for Reconciled Plan Year(s).
WHEREAS, Plan Sponsor wishes to engage PDA to assist Plan Sponsor with the requirements and
opportunities for Reopening the Reconciled Plan Year(s) and PDA desires to provide such
assistance, subject to the terms and conditions as set forth herein;
WHEREAS, Plan Sponsor (or its designee(s) other than PDA) shall serve as the administrator,
fiduciary and primary decision maker for the Plan, with all of the rights and responsibilities for
administering the Plan in connection with the Part D Program, and PDA shall have no such authority
or responsibility except as may be specifically provided herein.
NOW THEREFORE, in consideration of the mutual covenants and agreements herein contained,
the parties agree as follows:
SECTION 1
DEFINITIONS
1.01 “Medicare Eligible Individuals” shall mean a Member who has the right to elect to get
coverage under Medicare Part D, whether or not they have so elected. The determination of
whether a Member is a Medicare Eligible Individual shall be made monthly by CMS.
City of Nashua 1 SA Revised March 2016
