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Proving What’s Possible in Healthcare <br />This document contains important terms and conditions which are incorporated by reference into and becomes <br />part of the terms of your contract with us. ©2024, Healthcare Management Administrators, Inc. <br />14 <br />Actuarial Testing / Calculation Description of Service Price <br />PACE Fiduciary Service <br />The PACE Fiduciary Service provides final appeal determination <br />decisions on behalf of the plan.The Fiduciary Service is provided <br />by the Phia Group*, an expert in self-funded legal services. With <br />PACE, Phia reviews adverse benefit decisions made by the plan <br />and acts as the plan’s fiduciary to make final appeal determination <br />on the plan’s behalf. In addition, the Phia Group takes on liability <br />for damages that may result from an arbitrary or capricious claims <br />determination. <br />$2.10 PEPM <br />Part D Creditable <br />Coverage <br />Determination of employer prescription drug coverage meeting <br />Medicare's Creditable Coverage Requirements. Fees are per Plan <br />tested. <br />$468 <br />Premium Equivalent & <br />COBRA Rate Calculation <br />(Medical) <br />Calculation of premium equivalent rates & COBRA premiums for <br />Medical Plans (including pharmacy) in "Short Form" report format <br />for up to 3 Plans. “Long form” report format is available for $500 <br />per Plan. Additional Plans subject to additional fees -$1,500 per <br />Plan. <br />$4,675 <br />Premium Equivalent & <br />COBRA Rate Calculation <br />(Dental) <br />Calculation of premium equivalent rates & COBRA premiums for <br />Medical Plans (including pharmacy) in "Short Form" report format <br />for up to 3 Plans. Additional Plans subject to additional fees - <br />$600 per Plan. <br />$2,200 <br />Premium Equivalent & <br />COBRA Rate Calculation <br />(Vision) <br />Calculation of premium equivalent rates & COBRA premiums for <br />Medical Plans (including pharmacy) in "Short Form" report format <br />for up to 3 Plans. Additional Plans subject to additional fees - <br />$400 per Plan. <br />$1,375 <br />IBNR Reserve Calculation <br />(Medical) <br />Calculation of liability for claims incurred but not yet reported <br />(IBNR). Fees are per calculation.$1,375 <br />IBNR Reserve Calculation <br />(Dental) <br />Calculation of liability for claims incurred but not yet reported <br />(IBNR). Fees are per calculation.$990 <br />IBNR Reserve Calculation <br />(Vision) <br />Calculation of liability for claims incurred but not yet reported <br />(IBNR). Fees are per calculation.$825 <br />Actuarial and Compliance Services <br />We may receive revenue cost-share from vendor who provide services to the Plan Sponsor through our vendor contract.