Healthcare Management Administrators (HMA) 2/20/2025

HMA Client Intent & TPA Exhibit A – City of Everett 020188 Page 3 of 8 020188 City of Everett 2025.01 Client Intent Exhibit A_Single Year 5.14.2024 Vendor type Current vendor name Change? New vendor name & information Data Analytics Cedargate ☐ Other Vendor Vera Whole Health ☐ * Consumer-driven Health Plan (CDHP), e.g. HRA, FSA, HSA, LPFSA, DCRA. * Please note that if you choose to work with a non-preferred vendor, we may not be able to integrate eligibility, claims reporting, or accumulators and additional fees may apply. Fees Claim Administrative Fees Rates for the contracted time period apply to services administered by HMA. Fees for outside vendors are subject to change at any time. HMA fees and commissions may remain in effect beyond the above-stated term until changed by mutual written agreement of the parties. HMA reserves the right to pass through any and all regulatory assessments, fees, or similar financial obligations that are attributable to a client health plan whether known or not during the renewal process or that may become applicable during the term of HMA's services to a client and its health plan. HMA shall use reasonable efforts to identify and communicate to clients about assessments that it will be liable for but shall bear no liability for such obligations. Fee Product Description $18.45 Medical Plan Administration PEPM If all documents are signed and returned by 10/31/2024, the new PEPM with $.20 discount will be $18.25. $5.50 HMA PPO Network Access PEPM HMA Preferred provides access to Regence BlueShield in Western Washington, Asuris NW Health in Eastern Washington, Regence BlueCross BlueShield of Oregon, Regence BlueShield of Idaho, and Regence BlueCross BlueShield of Utah. PHCS provides network access in all other states. $3.75 Care Management PEPM HMA’s Care Management suite of services is an in-house program that encompasses pre-authorization, utilization management, case management, behavioral health, and steerage. HMA’s care management team serves members based upon their diagnosis offering full support of the member’s healthcare journey, as well as oversight of plan spend. • Utilization Review (Prior Authorization) including Population Health, Specialty Health, Intake • Case Management including Member Support (Clinical), Transition of Care, Continuity of Care, and Discharge Planning staffed by our in-house, highly skilled, certified Case Managers and Register Nurse (RN) Case Managers. Waived HCBB Comply Tool HMA’s shoppable services tool which is provided to you to satisfy federal transparency requirements. Additional cost-saving, utilization-driving features are available through the Healthcare Bluebook premium buy-up options. $0.45 Federal Transparency Technology Enablement PEPM Self-funded health plans are subject to seven new to ongoing and new transparency-related federal regulatory requirements. These requirements represent a massive technology lift and investment. We are passing through only a portion of the real costs of delivering these requirements. Docusign Envelope ID: CC50B3B8-52FD-4DD0-8AA5-5843B00BE3B8