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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 />Disclosures <br />Product/ Service Description of Disclosures <br />SPD, SBC, and Plan <br />Amendment Drafting <br />Support <br />We shall support the initial creation of your SBC, your SPD, and assist in preparation <br />of Plan amendments. In accordance with applicable federal and/or state <br />requirements, the Plan Sponsor must ensure timely approval and distribution of <br />plan documents to Plan Participants. We require a signed copy of the SPD provided <br />by the Plan Sponsor no later than one-hundred twenty (120) days after the start of <br />the Plan Year. For an additional fee, Plan Sponsor may request that we support <br />fulfillment and mailing of SPDs. <br />Data Integration with Third <br />Party Vendors <br />(Not Our Contracted <br />Partners) <br />We shall evaluate requests for the release of health plan data to third-party vendors <br />with whom the client has engaged directly. If the request is approved, client and its <br />vendor may be required to sign additional data protection agreements. We reserve <br />the right to charge a data integration fee for supporting the release of data to third <br />parties. <br />Actuarial and Compliance <br />Services –Washington <br />state-based employers <br />with Washington 1065 <br />The federal No Surprises Act protects your members from surprise billing for <br />emergency services. Plan Sponsors who wish to offer further protections for <br />members under the Washington state surprise billing law must opt-in directly with <br />Washington Office of the Insurance Commissioner and notify their account manager <br />a minimum of thirty (30) days prior to your effective date. <br />We do not provide support for any regulatory or compliance filings that are not <br />listed in this renewal document. The Plan Sponsor is responsible for 1) completing <br />any filings the Plan is required to file with state or federal agencies, 2) providing <br />mandated notices to plan participants (such as the Plan’s Notice of Privacy <br />Practices and Summary of Material Modifications). <br />Stop Loss <br />We require that client's partner with one of our Preferred stop loss Carriers SunLife <br />Financial, HM Insurance Group, QBE Insurance Corporation, Symetra Financial, <br />Tokio Marine HCC, Physicians Insurance, Commencement Bay Risk Managers, <br />SwissRe, Voya Financial, ISU w/Companion,Berkshire Hathaway,Medical Risk <br />Managers (MRM), Starline and iiSi. If we agree to work with a non-preferred stop <br />loss carrier, we will charge an Interface Fee of $3.50 PEPM.We reserve the right <br />decline to work with non-preferred stop loss carriers at our discretion. <br />36 <br />Please Note: the content in this and the accompanying Client Insights document is intended to be informational only and <br />cannot be relied upon as legal advice. The Plan Sponsor is ultimately responsible for the compliance of the Plan design and the <br />benefits offered.