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Exhibit
Kentucky Workers Compensation Attachment to Member Pharmacy Agreement
Notification participating as a Member Pharmacy under this Agreement, said member agrees to provide
pharmacy services
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How to fill out managed program agreement

How to fill out managed program agreement
01
To fill out the managed program agreement, follow these steps:
02
Review the entire agreement carefully to understand the terms and conditions.
03
Fill in the details of the managed program, including the program name, description, and objectives.
04
Provide information about the program manager, such as their name, contact details, and responsibilities.
05
Specify the scope and duration of the managed program.
06
Outline the services and deliverables to be provided under the program.
07
Include any additional terms or conditions that are specific to your agreement.
08
Review the completed agreement to ensure all necessary information is provided and that it accurately reflects the intentions of all parties involved.
09
Sign the agreement along with the authorized representatives of all parties involved.
10
Keep a copy of the agreement for your records.
Who needs managed program agreement?
01
Any organization or individual who wishes to engage in a managed program requires a managed program agreement.
02
This includes businesses, nonprofits, government agencies, and other entities that want to establish a formal agreement to define the rights, obligations, and responsibilities of the parties involved in managing a specific program.
03
The agreement ensures clarity and helps prevent misunderstandings or disputes by outlining the terms under which the program will be managed.
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What is managed program agreement?
A managed program agreement is a contract between a managed service provider and a client outlining the terms, deliverables, and responsibilities of the managed services.
Who is required to file managed program agreement?
Both the managed service provider and the client are required to file a managed program agreement.
How to fill out managed program agreement?
To fill out a managed program agreement, both parties must provide detailed information about the services to be provided, payment terms, and potential liabilities.
What is the purpose of managed program agreement?
The purpose of a managed program agreement is to establish a mutual understanding of the services being provided, expectations, and responsibilities of both parties.
What information must be reported on managed program agreement?
Information such as service level agreements, pricing, terms and conditions, termination clauses, and data protection measures must be reported on a managed program agreement.
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