Healthcare Management Administrators (HMA) 2/20/2025

HMA TPA Agreement Page 8 4/22 any vendors and/or products/services that are not procured through HMA’s contracts and partnerships. (d)Fees for Negotiated Savings. In the event that HMA is able to negotiate a reduced fee charged by a provider, HMA shall be entitled to retain a percentage of the negotiated savings as stated in the Claim Administrative Fee Schedule and/or Client Intent. In the event that additional negotiation services are needed, the Plan Sponsor and HMA shall mutually agree upon a fee schedule for such services. In the event that HMA is able to negotiate additional savings with a preferred (in-network) provider, fees for HMA’s negotiation services will only apply to the additional savings retained below the applicable network rate. (e)Shared Savings Programs. HMA offers a variety of Care Management and Condition Management solutions designed to steer utilization and care to optimal site of care and/or provider. HMA’s fees for these programs may include case rates and/or percentage of savings as shown within the current Client Intent and/or Claim Administrative Fee Schedule. HMA shall notify Plan Sponsor of new programs and solutions and advise of fees specific to each offering and provide the opportunity to include these programs within their scope of services with HMA. The Parties acknowledges that HMA and its affiliates have no obligation to pay rebates in connection with Covered Drugs dispensed by Providers and administered to Participants as part of a Covered Service. (f)Fees for Repricing of Out of Network Claims. HMA shall be entitled to retain 30% (thirty percent) of the gross savings obtained on all out of network claims that are repriced, reduced by negotiation or reduced due to audit. The remaining 70% (seventy percent) of savings will be passed on to the client in the form of reduced claims costs. There will be no cost to the Plan Sponsor for this service for claims that experience no repricing or negotiated savings. (g)Reprocessing Fee. In the event a retroactive amendment or the Plan Sponsor’s failure to fund claims in a timely manner results in the need to reprocess claims, the Plan Sponsor agrees to pay HMA’s reasonable expenses in performing that service. (h)Appeals and other PPACA Related Fees. Any fees incurred by HMA on behalf of the Plan for appeal related services, including but not limited to costs incurred by an Independent Review Organization, as well as fees incurred as a result of PPACA mandated services (i.e. language translation assistance services) shall be the sole responsibility of the Plan. (i)Bank fees and Charges. All bank related fees or transaction charges (Non- Sufficient Funds fees, dishonored checks, canceled ACH transfers, etc.) incurred by HMA in connection with the services provided to Plan Sponsor shall be the responsibility of Plan Sponsor. (j)Right to Change Fees. HMA shall have a right to change any fees charged to the Plan Sponsor hereunder (i)as of the first day of any Renewal Term;