Broker or Consultant Base Compensation. Not Applicable
Broker or Consultant Base Compensation. Medical Not Applicable
Broker or Consultant Base Compensation. Medical Broker or Consultant Fee is $22.50 per Subscriber per month and is included in the Base Administrative Services Fees described in Section 3(A) of this Schedule A. Upon receipt of payment from Employer, Anthem shall remit payment to the broker or consultant designated by Employer.
Broker or Consultant Base Compensation. Contract Year 2 (January 1, 2025 through December 31, 2025): A Consultant Annual Audit Fee of $55,000.00 shall be paid to the consultant designated by Client within thirty (30) days of receipt of invoice. Contract Year 3 (January 1, 2026 through December 31, 2026): A Consultant Annual Audit Fee of $55,000.00 shall be paid to the consultant designated by Client within thirty (30) days of receipt of invoice. ATTACHMENT 1 to EXHIBIT C ANCILLARY FEE SCHEDULE Table 1: Fees for Services Item Rate / Charge per Unit General Administration Account management Included at no cost Banking Included at no cost FSA feeds Included at no cost Implementation services Included at no cost Plan design strategy and consultation Included at no cost Pharmacy ID cards Included at no cost Standard communication materials to assist members with enrollment decisions and welcome them to their new plan when they enroll Included at no cost Plan benefit coding, testing and updates Included at no cost Eligibility updates (batch files, 834s, and/or client self-service tools) Included at no cost Access to Client self-service tool for real time eligibility updates, viewing of prior authorization status and viewing or reporting of utilization or other data Included at no cost Paper claims/member submitted claims processing $2.50 per Claim occurrence Standard coordination of benefits – Secondary Claim Processing $2.50 per Claim occurrence Customized communication materials $2.00 per letter Post Termination File Transfer Fee In the event of termination of the pharmacy contract, CarelonRx shall charge a fee of $5,000 per file for requested files including but not limited to open refill, prior authorization, claims history, and accumulators. Network Pharmacy Services Refill transfers, prior authorizations, claims history, and account balances files are each allowed a one-time transfer included at no cost. $5,000.00 per file fee applies for each subsequent file. Pharmacy help desk with toll-free number 24/7 support Included at no cost Pharmacy network management Included at no cost Pharmacy reimbursement Included at no cost Item Rate / Charge per Unit Standard daily Paid Claims file via Secure File Transfer Protocol Included at no cost Our Fraud, Waste and Abuse (FWA) Services includes two types of Pharmacy Network monitoring and audit capabilities: • Daily claims review and reprocessing Included at no cost • Pharmacy Network Audit/Investigative & onsite audits 100% of recoveries received are shar...
