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ATTACHMENT C <br /> CLAIMS ADMINISTRATION SERVICES <br /> PERFORMANCE REVIEWS <br /> The TPA and IRC agree that Performance Reviews will be conducted after the first year of <br /> operations. Each Performance Review will involve Claim File Reviews and an overall Program <br /> Management Review. Performance Reviews will be conducted by the Risk Manager,or the designee <br /> thereof. <br /> In the Claim File Review process, for each claim file that is reviewed, the reviewer will assign a <br /> score from 0 to 100 based upon the criteria outlined in this Attachment B. At the conclusion of <br /> reviewing all selected claim files,an average score for all claim files reviewed will be calculated. In <br /> the Program Management Review process,a separate single score between 0 and 100 will calculated. <br /> The average score for the Claim File Reviews will account for 90% of the overall scoring for the <br /> Performance Review. The total score for the Program Management Review will account for 10%of <br /> the overall scoring for the Performance Review. As an example, if the average WC Claim File <br /> Review score is 86 points, and the average Third Party Liability Claim File Review score is 90 <br /> points,and the Program Management Review score is 70 points,the total score will be calculated as <br /> follows: <br /> Third Party Liability Claim File Review 90 points times 40% weight = 36.0 points <br /> WC Claim File Review average 86 points times 50% weight= 43.0 points <br /> Program Management Review 70 points times 10% weight = 7.0 points <br /> Total Weighted Review Points 86.0 points <br /> The penalties will be based upon the Total Weighted Review Points. <br /> IRC will perform one Performance Review for each annual period of the contract. The following <br /> chart outlines the expected review schedule. IRC retains the right, at its sole discretion,to perform <br /> such reviews at any time. <br /> Performance Performance Period Total Weighted Penalty <br /> Review Review Points <br /> 1 Months 1 — 12 of Contract 80 1% <br /> 2 Months 13 —24 of Contract 90 1% <br /> 3 Months 25 —36 of Contract 95 1% <br /> 4 * Months 37 —48 of Contract 95 1% <br /> 5 * Months 49—60 of Contract 95 1% <br /> * If agreement extension authorized by IRC. <br /> Failure to perform at or above expected levels for the Performance Reviews will result in a financial <br /> penalty of I%of the amount that was charged by the TPA for the performance period. Any financial <br /> Page 22 <br />