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7978 - Amendment 1 Executed Docusign Transmittal Coversheet File Name Purchasing Contact Contract Expiration DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 12/30/27 7978 ASO for Medical Prescription Coverage - Amendment 1 Christa Christian 1 This Amendment (“Amendment”) is made to the Administrative Services Agreement (“Agreement”) by and between United HealthCare Services, Inc. and its affiliates (“United”) and City of Denton, Texas (“Customer”) and is effective on January 1, 2023. Contract No. 715130 – File 7978 - ASO for Medical Prescription Coverage Any capitalized terms used in this Amendment have the meanings shown in the Agreement. These terms may or may not have been capitalized in prior contractual documents between the parties but will have the same meaning as if capitalized. The Agreement is amended as follows: The Pharmacy Financials in Exhibit D-6 -Guarantees UnitedHealthcare in the Agreement is hereby deleted and replaced with the following: Pharmacy Financials Definition Contracted pharmacy rates that will be delivered to You. Measurement 01/01/2023 01/01/2024 01/01/2025 and Criteria Combined Discount Guarantee - Standard Select/CVS Network Retail Brand, Average Wholesale Price (AWP) less 23.5% 23.5% 23.5% Retail Generic, AWP less 84.0% 84.0% 84.0% Mail Order Brand, AWP less 25.5% 25.5% 25.5% Mail Order Generic, AWP less 86.0% 86.0% 86.0% The Guaranteed Discount amount will be determined by multiplying the AWP by the guaranteed discount off AWP by each component and adding the amounts together. Dispensing Fees - Standard Select/CVS Network Retail Brand $0.40 $0.40 $0.40 Retail Generic $0.40 $0.40 $0.40 Dispensing fee totals are calculated by multiplying the actual scripts for each type by the contracted rate for that script type. Minimum Rebate Guarantee (Traditional PDL) Rebate Sharing Percentage 95.0% 95.0% 95.0% Basis, per script Brand Brand Brand Retail - 30 and 90 Day $455.48 $533.90 $612.10 Mail Order $885.56 $937.93 $1,021.08 Specialty Included In Retail Included In Retail Included In Retail Level Customer Specific Period Annually Payment Period Annually Payment Amount -- Discounts The amount the actual discounts are less than the combined guaranteed Retail, Mail, and Specialty discount amount. Payment Amount -- Dispensing Fees The amount the combined actual dispensing fee exceeds the combined contracted dispensing fee. Payment Amount -- Rebates The amount the combined actual Rebate amount is less than the combined guaranteed Rebate amount. Conditions Discount & Dispense Fee Specific Conditions DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 2 • Discounts are based on actual Network Pharmacy brand and generic usage of retail and mail order drugs. The guaranteed discount amount will be determined by multiplying the AWP by the contracted discount rate off AWP by component. • Does not apply to items covered under the Plan for which no AWP measure exists. • Discounts calculated based on AWP less the ingredient cost; discount percentages are the discounts divided by the AWP. Discounts for retail and mail order generic prescriptions represent the average AWP based on savings off Maximum Allowable Cost (MAC) pricing for MAC generics and percentage discount savings off AWP for non-MAC generics. All other discounts represent the percentage discount savings off of AWP. • The arrangement excludes generic medications launched as an 'at-risk' product, generic medication with pending litigation, compound drugs, retail out of network claims, mail order drugs (for dispensing fee arrangement) and Indian Health Service Claims. • The Arrangement excludes usual & customary claims, vaccines, long term care facility claims, over-the- counter claims. • The Arrangement includes veterans’ affairs facility claims. • The retail and mail order generic discounts exclude any generic drug that has two or fewer generic manufacturers; the retail and mail order brand discounts include any generic drug that has two or fewer generic manufacturers. • The Mail Order guarantee includes drugs dispensed for 46 days or greater. • Specialty drugs dispensed outside United's specialty Pharmacy Network are included in the retail guarantees. Specialty drugs dispensed through United's specialty Pharmacy Network are excluded from the Retail and Mail guarantees. • Drugs in the following Specialty therapeutic categories are included in the retail guarantees: None. Rebate Specific Conditions • Assumes implementation of United's Traditional PDL • Client directed deviations from the PDL and PDL exclusions or uptiers, or clinical programs may result in changes to pricing and guarantees, which will be factored in at the time of rebate payment and/or reconciliation. • Calculation of the guaranteed rebate amount will exclude ineligible claims including claims where the plan is not the primary payer (e.g., coordination of benefits and subrogation claims), claims approved by formulary exception, claims not covered by Customer's benefit design or PDL, claims from 340B, long term care or federal government pharmacies, claims for non-FDA approved products, compound drugs, consumer card or discount card program claims and direct member reimbursement claims. • “Rebate Credit” is a credit towards the achievement of the guaranteed Rebate amount, and/or Rebate Fee Credit. The Rebate Credit is applied in the event of a change impacting the level of Rebates expected as a result of the availability of clinically comparable lower Rebate drugs. The Rebate Credit is calculated as the difference in pharmaceutical manufacturer revenue between what United would have invoiced pharmaceutical manufacturers if the Customer continued to prefer the originator brand product and the actual pharmaceutical manufacturer revenue received after favoring the new product (e.g. biosimilar, an authorized brand alternative, reduction of wholesale acquisition cost (WAC) on a Brand Drug subject to Rebates, launch of a lower cost non-Generic Drug alternative). The Rebate Credit does not apply to Generic Drugs that launch after the Brand Drug no longer has patent protection. United reserves the right to modify or eliminate this arrangement as follows based upon changes in Rebates: • if changes made to United's PDL, for the purpose of achieving a lower net drug cost for Customer and United's other ASO customers, result in significant reductions to the Rebate level • in the event that there are material deviations to the anticipated timing of drugs that will come off patent and no longer generate Rebates • if there is a change impacting the availability or amount of Rebates offered by drug manufacturer(s), including changes related to the elimination or material modification of a drug manufacturer(s) historic models or practices related to the provision of Rebates DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 3 • if Customer changes or does not elect an incented plan design • United will pay Rebates consistent with the Agreement. A reconciliation of the Rebate amounts will occur after the end of each annual contract period and when Rebate payments are substantially complete. The reconciliation calculates the minimum rebate amount by multiplying the actual number of scripts filled by the applicable rebate amount for that script type. • Specialty rebates are included in the guaranteed retail per-script rebates above. • Rebate Administrative Fee: United maintains systems and processes necessary for managing and administering Rebate programs. As consideration for these efforts, pharmaceutical manufacturers pay United administrative fees in addition to Rebates. Rebate Administration fees are included in the guaranteed rebate arrangement. • If Customer terminates pharmacy benefit services with United prior to the end of the Pharmacy Pricing Term, United will retain any and all pending or future Rebates payable under the Agreement as of the effective date of the termination of pharmacy benefit services. • Drugs in the following Specialty therapeutic categories are included in the retail per-Brand guarantees: None. • Over-the-counter and repackaged drugs, vaccines and devices are excluded from the claim counts (Insulins and Test Strips are not excluded). • Multisource brand drugs are excluded from the claim counts. • Limited distribution drugs are excluded from the claim counts General Conditions • All pricing guarantees shall remain in effect for the entire contract period of 01/01/2023 through 12/31/2025 ("Pharmacy Pricing Term"). Each twelve month period is a Guarantee Period. • Specialty drugs typically covered under the medical benefit (administered / handled by a provider, administered in a physician's office, ambulatory or home infusion), and/or transitioned to the pharmacy benefit, are excluded from all guarantees. • Drugs, products, supplies approved, covered and/or prescribed for the diagnosis, treatment or prevention of COVID-19 are excluded from all guarantees. • On mail order drugs, specialty drugs, and retail pharmacy drugs and services including dispensing fees, United will retain the difference between what United reimburses the Network Pharmacy and Customer's payment for a prescription drug product or service. • Pricing and guarantees assume enrollment of 1,513 Employees and 3,780 Participants; pricing and guarantees may be revised or withdrawn if actual enrollment varies by 10% or more from assumptions. • The lessor of three logic (non-ZBL) will apply to Participant payments. Participants pay the lessor of the discounted price, the usual and customary charge or the cost share amount. • All pricing guarantees require the selection of United as the exclusive mail provider. United will have no financial guarantee obligation under the Agreement for any partial Guarantee Period if Customer terminates prior to the end of the Pharmacy Pricing Term. • United shall on Customer’s behalf, administer a fee (“Consultant Fee”) to be paid to HonestRX (“Consultant”). The Consultant Fees are included in Customer’s pharmacy financial terms. United shall provide Consultant with a monthly payment for all Consultant Fees collected in the amount(s) of $4.00 pmpm and an annual $25,000 audit budget. The Customer acknowledges there is a contract between Customer and Consultant. Therefore, in the event that there is a dispute between Customer and Consultant over continuing to make the Consultant Fee payment(s) or in the delivery of consulting services, Customer shall hold United harmless in such disputes. In the event of any change whatsoever in the Consultant Fee, Customer shall immediately notify United of such change and United may propose changes to the pharmacy financial terms. DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 4 • United reserves the right to revise or revoke this arrangement if: a) changes in federal, state or other applicable law or regulation require modifications; b) there are material changes to the AWP as published by the pricing agency that establishes the AWP as used in these arrangements; c) Customer makes benefit changes that impact the arrangements; d) there is a material industry change in pricing methodologies resulting in a new source or benchmark; e) it is not accepted within ninety (90) days of the issuance of our initial quote; f) if Customer changes their mail service benefit; g) Customer utilizes a vendor, that facilitates steering members to different drugs or pharmacies to the extent these services impact the financial guarantees under this Agreement. TRRX (02/2022) DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 1 Specialty Pharmacy Specialty Pharmacy Discount Guarantee Definition Specialty drug discount level based on actual specialty drug utilization for the specialty drugs dispensed through United's specialty Pharmacy Network. United reserves the right to change the designation of a drug from specialty to non-specialty based on market conditions. Measurement A composite of 19.0% for drugs dispensed through United's specialty Pharmacy Network. This guarantee is effective 01/01/2023 through 12/31/2023. See chart below for a list of Specialty Drugs. A composite of 19.0% for drugs dispensed through United's specialty Pharmacy Network. This guarantee is effective 01/01/2024 through 12/31/2024. See chart below for a list of Specialty Drugs. A composite of 19.0% for drugs dispensed through United's specialty Pharmacy Network. This guarantee is effective 01/01/2025 through 12/31/2025. See chart below for a list of Specialty Drugs. Specialty drugs not included on the list below and dispensed through United's specialty Pharmacy Network will be guaranteed at a discount of 14.0%. Criteria Actual utilization, using Average Wholesale Price (AWP) in dollars, using our data, of listed specialty drugs through Our specialty Pharmacy Network will be multiplied against the discount target to determine the overall discount target dollars. The overall discount target dollars may be adjusted based on utilization of unlisted drugs to which the separate 14.0% discount applies. This total will be compared to actual discounts achieved for these drugs during the Guarantee Period. Level Customer Specific Period Annual Payment Period Annual Payment Amount The amount the actual discounts are less than the combined guaranteed Retail, Mail, and Specialty discount amount. Conditions • Discounts calculated based on the AWP less the ingredient cost; discount percentages are the discounts divided by the AWP. Discounts for retail generic prescriptions represent the average savings off AWP based on Maximum Allowable Cost (MAC) pricing for MAC generics and percentage discount savings off AWP for non-MAC generics. All other discounts represent the percentage discount savings off of AWP. • Specialty drugs dispensed outside United's specialty Pharmacy Network, drugs for which no AWP measure exists and non-drug items are excluded. DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 2 • Listed drugs which cease to be defined as specialty drugs during the Guarantee Period will be reconciled outside of the Specialty Pharmacy guarantee in the channel in which they are dispensed (retail or mail order). • Specialty drugs typically covered under the medical benefit (administered / handled by a provider, administered in a physician's office, ambulatory or home infusion), and/or transitioned to the pharmacy benefit, are excluded from all guarantees. • United reserves the right to revise or revoke this guarantee if: a) changes in federal, state or other applicable law or regulation require modifications; b) there are material changes to the AWP as published by the pricing agency that establishes the AWP as used in this guarantee; c) Customer makes benefit changes that impact the guarantee; d) there is a material industry change in pricing methodologies resulting in a new source or benchmark e) if actual specialty utilization is not substantially similar to that in the experience period data on which our quote is based. • On specialty drugs, United will retain the difference between what United reimburses the Network Pharmacy and Customer's payment for a prescription drug product or service. Specialty Drug Category Drug Name Included/Excluded From Guarantee Specialty Drug Category Drug Name Included/Excluded From Guarantee ANEMIA ARANESP Included INFLAMMATORY CONDITIONS ILUMYA Included ANEMIA EPOGEN Included INFLAMMATORY CONDITIONS KEVZARA Included ANEMIA PROCRIT Included INFLAMMATORY CONDITIONS KINERET Included ANEMIA RETACRIT Included INFLAMMATORY CONDITIONS OLUMIANT Included ANTICONVULSANT DIACOMIT Included INFLAMMATORY CONDITIONS ORENCIA Included ANTICONVULSANT EPIDIOLEX Included INFLAMMATORY CONDITIONS OTEZLA Included ANTICONVULSANT FINTEPLA Included INFLAMMATORY CONDITIONS RIDAURA Included ANTIHYPERLIPIDEMIC JUXTAPID Included INFLAMMATORY CONDITIONS RINVOQ Included ANTI-INFECTIVE ARIKAYCE Included INFLAMMATORY CONDITIONS SILIQ Included ANTI-INFECTIVE DARAPRIM Included INFLAMMATORY CONDITIONS SIMPONI Included ANTI-INFECTIVE PYRIMETHAMINE Included INFLAMMATORY CONDITIONS SKYRIZI Included ASTHMA FASENRA Included INFLAMMATORY CONDITIONS STELARA Included ASTHMA NUCALA Included INFLAMMATORY CONDITIONS TALTZ Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 3 ASTHMA XOLAIR Included INFLAMMATORY CONDITIONS TREMFYA Included CARDIOVASCULAR DROXIDOPA Included INFLAMMATORY CONDITIONS XELJANZ Included CARDIOVASCULAR NORTHERA Included INFLAMMATORY CONDITIONS XELJANZ XR Included CARDIOVASCULAR VYNDAMAX Included IRON OVERLOAD DEFERASIROX Included CARDIOVASCULAR VYNDAQEL Included IRON OVERLOAD EXJADE Included CNS AGENTS AUSTEDO Included IRON OVERLOAD FERRIPROX Included CNS AGENTS ENSPRYNG Included IRON OVERLOAD JADENU Included CNS AGENTS FIRDAPSE Included LIVER DISEASE OCALIVA Included CNS AGENTS HETLIOZ Included MONOCLONAL ANTIBODY MISCELLANEOUS BENLYSTA Included CNS AGENTS INGREZZA Included MOOD DISORDER DRUGS SPRAVATO Included CNS AGENTS RILUTEK Included MULTIPLE SCLEROSIS AMPYRA Included CNS AGENTS RILUZOLE Included MULTIPLE SCLEROSIS AUBAGIO Included CNS AGENTS RUZURGI Included MULTIPLE SCLEROSIS AVONEX Included CNS AGENTS SABRIL Included MULTIPLE SCLEROSIS BAFIERTAM Included CNS AGENTS TETRABENAZINE Included MULTIPLE SCLEROSIS BETASERON Included CNS AGENTS TIGLUTIK Included MULTIPLE SCLEROSIS COPAXONE Included CNS AGENTS VIGABATRIN Included MULTIPLE SCLEROSIS DALFAMPRIDIN Included CNS AGENTS VIGADRONE Included MULTIPLE SCLEROSIS DIMETHYL FUMARATE Included CNS AGENTS XENAZINE Included MULTIPLE SCLEROSIS EXTAVIA Included CNS AGENTS XYREM Included MULTIPLE SCLEROSIS GILENYA Included CNS AGENTS XYWAV Included MULTIPLE SCLEROSIS GLATIRAMER Included CYSTIC FIBROSIS BETHKIS Included MULTIPLE SCLEROSIS GLATOPA Included CYSTIC FIBROSIS CAYSTON Included MULTIPLE SCLEROSIS KESIMPTA Included CYSTIC FIBROSIS KALYDECO Included MULTIPLE SCLEROSIS MAVENCLAD Included CYSTIC FIBROSIS KITABIS PAK Included MULTIPLE SCLEROSIS MAYZENT Included CYSTIC FIBROSIS ORKAMBI Included MULTIPLE SCLEROSIS PLEGRIDY Included CYSTIC FIBROSIS PULMOZYME Included MULTIPLE SCLEROSIS PONVORY Included CYSTIC FIBROSIS SYMDEKO Included MULTIPLE SCLEROSIS REBIF Included CYSTIC FIBROSIS TOBI Included MULTIPLE SCLEROSIS REBIF REBIDOSE Included CYSTIC FIBROSIS TOBI PODHALER Included MULTIPLE SCLEROSIS TECFIDERA Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 4 CYSTIC FIBROSIS TOBRAMYCIN Included MULTIPLE SCLEROSIS VUMERITY Included CYSTIC FIBROSIS TRIKAFTA Included MULTIPLE SCLEROSIS ZEPOSIA Included ENDOCRINE BUPHENYL Included MUSCULOSKELETAL AGENTS EVRYSDI Included ENDOCRINE BYNFEZIA Included NARCOLEPSY WAKIX Included ENDOCRINE CARBAGLU Included NEUTROPENIA FULPHILA Included ENDOCRINE CHENODAL Included NEUTROPENIA GRANIX Included ENDOCRINE CLOVIQUE Included NEUTROPENIA LEUKINE Included ENDOCRINE CUPRIMINE Included NEUTROPENIA NEULASTA Included ENDOCRINE CYSTADANE Included NEUTROPENIA NEUPOGEN Included ENDOCRINE CYSTADROPS Included NEUTROPENIA NIVESTYM Included ENDOCRINE CYSTARAN Included NEUTROPENIA NYVEPRIA Included ENDOCRINE DEPEN TITRATABS Included NEUTROPENIA UDENYCA Included ENDOCRINE D-PENAMINE Included NEUTROPENIA ZARXIO Included ENDOCRINE EGRIFTA Included NEUTROPENIA ZIEXTENZO Included ENDOCRINE FIRMAGON Included ONCOLOGY - INJECTABLE ELIGARD Included ENDOCRINE GATTEX Included ONCOLOGY - INJECTABLE INTRON A Included ENDOCRINE H.P. ACTHAR Included ONCOLOGY - INJECTABLE LEUPROLIDE Included ENDOCRINE IMCIVREE Included ONCOLOGY - INJECTABLE SYNRIBO Included ENDOCRINE ISTURISA Included ONCOLOGY - ORAL ABIRATERONE Included ENDOCRINE JYNARQUE Included ONCOLOGY - ORAL AFINITOR Included ENDOCRINE KEVEYIS Included ONCOLOGY - ORAL AFINITOR DISPERZ Included ENDOCRINE KORLYM Included ONCOLOGY - ORAL ALECENSA Included ENDOCRINE KUVAN Included ONCOLOGY - ORAL ALKERAN Included ENDOCRINE MYALEPT Included ONCOLOGY - ORAL ALUNBRIG Included ENDOCRINE NATPARA Included ONCOLOGY - ORAL AYVAKIT Included ENDOCRINE NITYR Included ONCOLOGY - ORAL BALVERSA Included ENDOCRINE OCTREOTIDE ACETATE Included ONCOLOGY - ORAL BEXAROTENE Included ENDOCRINE PENICILLAMINE Included ONCOLOGY - ORAL BOSULIF Included ENDOCRINE PROCYSBI Included ONCOLOGY - ORAL BRAFTOVI Included ENDOCRINE RAVICTI Included ONCOLOGY - ORAL BRUKINSA Included ENDOCRINE SAMSCA Included ONCOLOGY - ORAL CABOMETYX Included ENDOCRINE SANDOSTATIN Included ONCOLOGY - ORAL CALQUENCE Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 5 ENDOCRINE SAPROPTERIN Included ONCOLOGY - ORAL CAPECITABINE Included ENDOCRINE SIGNIFOR Included ONCOLOGY - ORAL CAPRELSA Included ENDOCRINE SODIUM PHENYLBUTYRATE Included ONCOLOGY - ORAL COMETRIQ Included ENDOCRINE SOMATULINE DEPOT Included ONCOLOGY - ORAL COPIKTRA Included ENDOCRINE SOMAVERT Included ONCOLOGY - ORAL COTELLIC Included ENDOCRINE SYPRINE Included ONCOLOGY - ORAL DAURISMO Included ENDOCRINE THIOLA Included ONCOLOGY - ORAL ERIVEDGE Included ENDOCRINE TOLVAPTAN Included ONCOLOGY - ORAL ERLEADA Included ENDOCRINE TRIENTINE Included ONCOLOGY - ORAL ERLOTINIB Included ENDOCRINE XERMELO Included ONCOLOGY - ORAL ETOPOSIDE Included ENDOCRINE XURIDEN Included ONCOLOGY - ORAL EVEROLIMUS Included ENZYME DEFICIENCY CHOLBAM Included ONCOLOGY - ORAL FARYDAK Included ENZYME DEFICIENCY CYSTAGON Included ONCOLOGY - ORAL FOTIVDA Included ENZYME DEFICIENCY GALAFOLD Included ONCOLOGY - ORAL GILOTRIF Included ENZYME DEFICIENCY MIGLUSTAT Included ONCOLOGY - ORAL GLEEVEC Included ENZYME DEFICIENCY NITISINONE Included ONCOLOGY - ORAL GLEOSTINE Included ENZYME DEFICIENCY ORFADIN Included ONCOLOGY - ORAL HYCAMTIN Included ENZYME DEFICIENCY PALYNZIQ Included ONCOLOGY - ORAL IBRANCE Included ENZYME DEFICIENCY STRENSIQ Included ONCOLOGY - ORAL ICLUSIG Included ENZYME DEFICIENCY SUCRAID Included ONCOLOGY - ORAL IDHIFA Included ENZYME DEFICIENCY TEGSEDI Included ONCOLOGY - ORAL IMATINIB MESYLATE Included ENZYME DEFICIENCY ZAVESCA Included ONCOLOGY - ORAL IMBRUVICA Included GAUCHERS DISEASE CERDELGA Included ONCOLOGY - ORAL INLYTA Included GENETIC DISORDER DOJOLVI Included ONCOLOGY - ORAL INQOVI Included GENETIC DISORDER ZOKINVY Included ONCOLOGY - ORAL INREBIC Included GROWTH HORMONE DEFICIENCY GENOTROPIN Included ONCOLOGY - ORAL IRESSA Included GROWTH HORMONE DEFICIENCY HUMATROPE Included ONCOLOGY - ORAL JAKAFI Included GROWTH HORMONE DEFICIENCY INCRELEX Included ONCOLOGY - ORAL KISQALI Included GROWTH HORMONE DEFICIENCY NORDITROPIN Included ONCOLOGY - ORAL KISQALI FEMARA Included GROWTH HORMONE DEFICIENCY NUTROPIN AQ Included ONCOLOGY - ORAL KOSELUGO Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 6 GROWTH HORMONE DEFICIENCY OMNITROPE Included ONCOLOGY - ORAL LAPATINIB Included GROWTH HORMONE DEFICIENCY SAIZEN Included ONCOLOGY - ORAL LENVIMA Included GROWTH HORMONE DEFICIENCY SEROSTIM Included ONCOLOGY - ORAL LONSURF Included GROWTH HORMONE DEFICIENCY ZOMACTON Included ONCOLOGY - ORAL LORBRENA Included GROWTH HORMONE DEFICIENCY ZORBTIVE Included ONCOLOGY - ORAL LUMAKRAS Included HEMATOLOGIC BERINERT Included ONCOLOGY - ORAL LYNPARZA Included HEMATOLOGIC CABLIVI Included ONCOLOGY - ORAL MATULANE Included HEMATOLOGIC CINRYZE Included ONCOLOGY - ORAL MEKINIST Included HEMATOLOGIC DOPTELET Included ONCOLOGY - ORAL MEKTOVI Included HEMATOLOGIC FIRAZYR Included ONCOLOGY - ORAL MELPHALAN Included HEMATOLOGIC HAEGARDA Included ONCOLOGY - ORAL MESNEX Included HEMATOLOGIC ICATIBANT Included ONCOLOGY - ORAL NERLYNX Included HEMATOLOGIC MOZOBIL Included ONCOLOGY - ORAL NEXAVAR Included HEMATOLOGIC MULPLETA Included ONCOLOGY - ORAL NILANDRON Included HEMATOLOGIC OXBRYTA Included ONCOLOGY - ORAL NILUTAMIDE Included HEMATOLOGIC PROMACTA Included ONCOLOGY - ORAL NINLARO Included HEMATOLOGIC RUCONEST Included ONCOLOGY - ORAL NUBEQA Included HEMATOLOGIC SAJAZIR Included ONCOLOGY - ORAL ODOMZO Included HEMATOLOGIC TAKHZYRO Included ONCOLOGY - ORAL ONUREG Included HEMATOLOGIC TAVALISSE Included ONCOLOGY - ORAL ORGOVYX Included HEMOPHILIA - INFUSED ADVATE Included ONCOLOGY - ORAL PEMAZYRE Included HEMOPHILIA - INFUSED ADYNOVATE Included ONCOLOGY - ORAL PIQRAY Included HEMOPHILIA - INFUSED AFSTYLA Included ONCOLOGY - ORAL POMALYST Included HEMOPHILIA - INFUSED ALPHANATE/VON WILLEBRAND Included ONCOLOGY - ORAL PURIXAN Included HEMOPHILIA - INFUSED ALPHANINE SD Included ONCOLOGY - ORAL QINLOCK Included HEMOPHILIA - INFUSED ALPROLIX Included ONCOLOGY - ORAL RETEVMO Included HEMOPHILIA - INFUSED BENEFIX Included ONCOLOGY - ORAL REVLIMID Included HEMOPHILIA - INFUSED COAGADEX Included ONCOLOGY - ORAL ROZLYTREK Included HEMOPHILIA - INFUSED CORIFACT Included ONCOLOGY - ORAL RUBRACA Included HEMOPHILIA - INFUSED ELOCTATE Included ONCOLOGY - ORAL RYDAPT Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 7 HEMOPHILIA - INFUSED ESPEROCT Included ONCOLOGY - ORAL SPRYCEL Included HEMOPHILIA - INFUSED FEIBA Included ONCOLOGY - ORAL STIVARGA Included HEMOPHILIA - INFUSED HEMOFIL M Included ONCOLOGY - ORAL SUNITINIB Included HEMOPHILIA - INFUSED HUMATE-P Included ONCOLOGY - ORAL SUTENT Included HEMOPHILIA - INFUSED IDELVION Included ONCOLOGY - ORAL TABLOID Included HEMOPHILIA - INFUSED IXINITY Included ONCOLOGY - ORAL TABRECTA Included HEMOPHILIA - INFUSED JIVI Included ONCOLOGY - ORAL TAFINLAR Included HEMOPHILIA - INFUSED KOATE Included ONCOLOGY - ORAL TAGRISSO Included HEMOPHILIA - INFUSED KOATE-DVI Included ONCOLOGY - ORAL TALZENNA Included HEMOPHILIA - INFUSED KOGENATE FS Included ONCOLOGY - ORAL TARCEVA Included HEMOPHILIA - INFUSED KOVALTRY Included ONCOLOGY - ORAL TARGRETIN Included HEMOPHILIA - INFUSED MONONINE Included ONCOLOGY - ORAL TASIGNA Included HEMOPHILIA - INFUSED NOVOEIGHT Included ONCOLOGY - ORAL TAZVERIK Included HEMOPHILIA - INFUSED NOVOSEVEN RT Included ONCOLOGY - ORAL TEMODAR Included HEMOPHILIA - INFUSED NUWIQ Included ONCOLOGY - ORAL TEMOZOLOMIDE Included HEMOPHILIA - INFUSED PROFILNINE Included ONCOLOGY - ORAL TEPMETKO Included HEMOPHILIA - INFUSED REBINYN Included ONCOLOGY - ORAL THALOMID Included HEMOPHILIA - INFUSED RECOMBINATE Included ONCOLOGY - ORAL TIBSOVO Included HEMOPHILIA - INFUSED RIXUBIS Included ONCOLOGY - ORAL TRETINOIN Included HEMOPHILIA - INFUSED SEVENFACT Included ONCOLOGY - ORAL TUKYSA Included HEMOPHILIA - INFUSED TRETTEN Included ONCOLOGY - ORAL TURALIO Included HEMOPHILIA - INFUSED VONVENDI Included ONCOLOGY - ORAL TYKERB Included HEMOPHILIA - INFUSED WILATE Included ONCOLOGY - ORAL UKONIQ Included HEMOPHILIA - INFUSED XYNTHA Included ONCOLOGY - ORAL VENCLEXTA Included HEMOPHILIA - INJECTABLE HEMLIBRA Included ONCOLOGY - ORAL VERZENIO Included HEPATITIS B ADEFOVIR DIPIVOXIL Included ONCOLOGY - ORAL VITRAKVI Included HEPATITIS B BARACLUDE Included ONCOLOGY - ORAL VIZIMPRO Included HEPATITIS B EMPAVELI Included ONCOLOGY - ORAL VOTRIENT Included HEPATITIS B ENTECAVIR Included ONCOLOGY - ORAL XALKORI Included HEPATITIS B EPIVIR HBV Included ONCOLOGY - ORAL XELODA Included HEPATITIS B HEPSERA Included ONCOLOGY - ORAL XOSPATA Included HEPATITIS B LAMIVUDINE HBV Included ONCOLOGY - ORAL XPOVIO Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 8 HEPATITIS B VEMLIDY Included ONCOLOGY - ORAL XTANDI Included HEPATITIS C EPCLUSA Included ONCOLOGY - ORAL YONSA Included HEPATITIS C HARVONI Included ONCOLOGY - ORAL ZEJULA Included HEPATITIS C LEDIPASVIR/SOFOSBUVIR Included ONCOLOGY - ORAL ZELBORAF Included HEPATITIS C MAVYRET Included ONCOLOGY - ORAL ZOLINZA Included HEPATITIS C PEGASYS Included ONCOLOGY - ORAL ZYDELIG Included HEPATITIS C PEGINTRON Included ONCOLOGY - ORAL ZYKADIA Included HEPATITIS C SOFOSBUVIR/VELPATASV IR Included ONCOLOGY - ORAL ZYTIGA Included HEPATITIS C SOVALDI Included ONCOLOGY - TOPICAL TARGRETIN Included HEPATITIS C VIEKIRA PAK Included ONCOLOGY - TOPICAL VALCHLOR Included HEPATITIS C VOSEVI Included OPHTHALMIC OXERVATE Included HEPATITIS C ZEPATIER Included OSTEOPOROSIS FORTEO Included HEREDITARY ANGIODEMA ORLADEYO Included OSTEOPOROSIS TERIPARATIDE Included IMMUNE MODULATOR ACTIMMUNE Included OSTEOPOROSIS TYMLOS Included IMMUNE MODULATOR ARCALYST Included PARKINSONS DISEASE APOKYN Included IMMUNOLOGICAL AGENTS LUPKYNIS Included PARKINSONS DISEASE INBRIJA Included IMMUNOLOGICAL AGENTS PALFORZIA Included PARKINSONS DISEASE KYNMOBI Included INFERTILITY CETROTIDE Included PULMONARY DISEASE ESBRIET Included INFERTILITY CHORIONIC GONADOTROPIN Included PULMONARY DISEASE OFEV Included INFERTILITY FOLLISTIM AQ Included PULMONARY HYPERTENSION ADCIRCA Included INFERTILITY GANIRELIX ACETATE Included PULMONARY HYPERTENSION ADEMPAS Included INFERTILITY GONAL-F Included PULMONARY HYPERTENSION ALYQ Included INFERTILITY GONAL-F RFF Included PULMONARY HYPERTENSION AMBRISENTAN Included INFERTILITY MENOPUR Included PULMONARY HYPERTENSION BOSENTAN Included INFERTILITY NOVAREL Included PULMONARY HYPERTENSION LETAIRIS Included INFERTILITY OVIDREL Included PULMONARY HYPERTENSION OPSUMIT Included INFERTILITY PREGNYL Included PULMONARY HYPERTENSION ORENITRAM Included INFLAMMATORY ACTEMRA Included PULMONARY REVATIO Included DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 9 CONDITIONS HYPERTENSION INFLAMMATORY CONDITIONS CIMZIA Included PULMONARY HYPERTENSION SILDENAFIL Included INFLAMMATORY CONDITIONS COSENTYX Included PULMONARY HYPERTENSION TADALAFIL Included INFLAMMATORY CONDITIONS DUPIXENT Included PULMONARY HYPERTENSION TRACLEER Included INFLAMMATORY CONDITIONS EMFLAZA Included PULMONARY HYPERTENSION TYVASO Included INFLAMMATORY CONDITIONS ENBREL Included PULMONARY HYPERTENSION UPTRAVI Included INFLAMMATORY CONDITIONS HUMIRA Included PULMONARY HYPERTENSION VENTAVIS* Included *Includes Nebulizer 10/2021 DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 1 This Amendment will not affect any of the terms, provisions or conditions of the Agreement except as stated herein. City of Denton, Texas United HealthCare Services, Inc. By ________________________________ By ________________________________ Authorized Signature Authorized Signature Name ________________________________ Name ________________________________ Title ________________________________ Title ________________________________ Date ________________________________ Date ________________________________ ASA AMEND 7.2016 DocuSign Envelope ID: 612F2904-7C5A-4037-AE70-85200E19B75E 2/6/2023 Christa Christian Senior Buyer Marti Skinner 2/7/2023 Associate Contract Manager Certificate Of Completion Envelope Id: 612F29047C5A4037AE7085200E19B75E Status: Completed Subject: 7978 - ASO for Medical Prescription Coverage, Amendment 1 Source Envelope: Document Pages: 15 Signatures: 2 Envelope Originator: Certificate Pages: 5 Initials: 0 Christa Christian AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 901B Texas Street Denton, TX 76209 Christa.Christian@cityofdenton.com IP Address: 198.49.140.10 Record Tracking Status: Original 2/6/2023 4:54:31 PM Holder: Christa Christian Christa.Christian@cityofdenton.com Location: DocuSign Signer Events Signature Timestamp Christa Christian christa.christian@cityofdenton.com Senior Buyer City of Denton Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.49.140.10 Sent: 2/6/2023 5:06:52 PM Viewed: 2/6/2023 5:07:02 PM Signed: 2/6/2023 5:07:18 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Marti Skinner martha_skinner@uhc.com Associate Contract Manager Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 198.203.181.181 Sent: 2/6/2023 5:07:22 PM Viewed: 2/7/2023 7:00:38 PM Signed: 2/7/2023 7:01:21 PM Electronic Record and Signature Disclosure: Accepted: 2/7/2023 7:00:38 PM ID: 469fd8db-22a2-4c6d-847d-2d2f25cc1f2f In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Linda Kyle linda.kyle@cityofdenton.com Security Level: Email, Account Authentication (None) Sent: 2/7/2023 7:01:25 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Carbon Copy Events Status Timestamp Cheyenne Defee cheyenne.defee@cityofdenton.com Procurement Administration Supervisor City of Denton Security Level: Email, Account Authentication (None) Sent: 2/7/2023 7:01:27 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Deby Skawinski Deby.Skawinski@cityofdenton.com Deputy Director, Risk & Compliance Security Level: Email, Account Authentication (None) Sent: 2/7/2023 7:01:27 PM Electronic Record and Signature Disclosure: Accepted: 2/7/2023 2:22:15 PM ID: b00fc7b0-5b62-4d3b-92bd-4f34c0b9c2eb Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 2/6/2023 5:06:52 PM Certified Delivered Security Checked 2/7/2023 7:00:38 PM Signing Complete Security Checked 2/7/2023 7:01:21 PM Completed Security Checked 2/7/2023 7:01:27 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, City of Denton (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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