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2. Pricing Valid July 1, 2023 to June 30, 2024 <br />Workers' Com I ensation Claims Administration <br />Description <br />Cit of Everett <br />Pricing <br />Life of Contract Flat Annual Fee <br />Up to 90 Indemnity & 100 Medical Only Claims Annually <br />Per claim Fee after maximum number of claims: <br />Medical -Only <br />Indemnity <br />Employer's Liability <br />Program Management <br />$110,544.30 <br />$164.75 <br />$1,208.13 <br />$1,208.13 <br />Description <br />Pricing <br />Data Conversion - Per Data Source <br />Waived <br />Administration Fee - Per Annum 1 <br />$13,179.65 <br />Implementation Fee - One Time Fee <br />Waived <br />CareMC Access - Per Annum 2 <br />First 6 Full Access Users <br />Each User over 6 - Per User, Per Year <br />Included <br />$1,000.00 <br />State Fund Oversight (OH, WA) <br />50% of standard fees, based on <br />service level <br />Archive Storage Expenses3 <br />Pass through expense from Access <br />1 Includes Assistance with Self -Insured Data for State Reports. State Statistical Reporting & All State Filing <br />Requirements <br />2 Includes Executive Dashboard, Claim Details, Claims Summary Screen & Claims Reporting <br />3 In the event City of Everett takes custody of the physical files and the Access account is closed, this charge will no <br />longer apply. <br />Account Management and Technical Suuuort <br />Description <br />Account Management Staff <br />Pricing <br />Included <br />Electronic Data Transmission - (Per Month, Based on Frequency) <br />Monthly File <br />Weekly File <br />Daily File <br />$250.00 <br />$600.00 <br />$2,000.00 <br />Training — Onsite and Online <br />Included <br />Technical Support <br />Included <br />State EDI Files <br />Included <br />Monthly Reporting <br />Included <br />Ad hoc Report Programming - Per Hour <br />$200.00 <br />Communication Materials/Posters <br />Pass through printing cost <br />Annual Banking Fees <br />One account included <br />$1,000.00 <br />Additional Account(s) - Per Account <br />Carrier TPA Oversight Fees 1 <br />Bill from Carrier to Client <br />1 Fees charged by the carrier (Oversight fees, Tail Claim transfer / takeover fees, etc.) are the responsibility of the client <br />and will be billed directly to the client by the carrier or by CorVel should CorVel be invoiced for such fees. <br />Intake and Immediate Intervention Services <br />Descri s tion <br />Pricin <br />Claim Intake (includes one FNOL distribution) - Per Intake <br />$32.95 <br />Incident Only Reporting - Per Incident <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />$32.95 <br />