(e) Assist in the design and establishment of a system for the proper retention of
relevant data as may be proper and necessary for compliance with the Part D
Program and any audits by CMS in connection with the Medicare Drug Subsidies
for the Reconciled Plan Year.
2.02 Specific PDA Services — Ongoing Services. During the term of this Agreement, PDA shall
provide the following ongoing services:
(a) Maintain and update a database containing the eligibility of each Retired Medicare
Eligible Individual for prescription drug coverage under the Plan and/or under the
Part D Program with respect to each Reconciled Plan Year;
(b) Maintain other appropriate records regarding the Plan in respect of the Part D
Program as may be required by federal law; and
(c) Assist Plan Sponsor with submission of, or access to, the records in PDA’s database
as may be required for CMS regulatory, audit, and/or other business purposes.
2.03 Sources of Information. In performance of the above-described services, PDA shall rely on
any communication and/or data reasonably believed by it to be genuine, including necessary
information received from Plan Sponsor, Members, providers, and any other source in a
timely manner and in good order. For purposes hereof, “timely manner” means a reasonable
period of time as may be necessary for sorting, processing, analyzing, entering and/or
posting of information received.
SECTION 3
RESPONSIBILITIES OF PLAN SPONSOR
3.01 Preparation and Provision of Eligibility List and Plan Information. Plan Sponsor shall:
(a) Prepare a complete and accurate set of enrollment records for all Members under the
Plan during the Reconciled Plan Year including actual retirement dates. Such
records shall be delivered to PDA in an electronic format acceptable to PDA as soon
as practicable following the Effective Date. Thereafter, Plan Sponsor shall promptly
update such enrollment records in an electronic format acceptable to PDA, notifying
PDA of any and all changes in Member status and the accurate date of such change,
including the addition of new Members, retirement, termination or layoff of a
Member, changes in dependent status or any other changes that may affect the
eligibility of a Member;
(b) Make available, or cause to be made available to PDA, certain reports and
information to which Plan Sponsor has access and which may be reasonably
requested by PDA. Such reports and information may include, but shall not be
limited to: (1) certification that a Member was eligible for benefits under the Plan;
(ii) a description and identification of the types of drug benefits to which a Member
was entitled; (iii) date of a Member’s eligibility; and (iv) date of a Member’s
ineligibility. Upon request, Plan Sponsor shall provide PDA with any other
reasonable and necessary information regarding Members;
City of Nashua 3 SA Revised March 2016
