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Consumer Driven Health CD Solution <br />Customer service for Members <br />-Comprehensive <br />Consumer Choice Plan <br />All services: $0.65 PMPM <br />Technical <br />• Technical and Member Advocacy: $0.35 <br />Bi-directional data exchange; dedicated operations; 24-hour <br />PMPM <br />a day, seven -days a week monitoring and quality control; <br />• Health Choices and Drug Choices: $0.30 <br />performance reporting; and analytics <br />PMPM <br />Member Advocacy <br />Benefit education Prescription delivery – standard <br />Dedicated CDH member services, open enrollment tools <br />• Web -based client reporting – • Annual Strategic Account Plan report <br />and member communications library, robust online <br />'these charges would be in addition to any pricing <br />features, and preventive care <br />adjustments if greater than ten percent of Client's <br />Health Choices <br />total utilization for all Plans is attributable to a <br />Medication Adherence Monitoring and Outreach and <br />CDHC. <br />proactive, personalized member communications <br />Drug Choices <br />Benefit Coaching, Prescription Benefit Review Statements, <br />proactive, personalized member communications <br />Medicare Part D – Retiree Drug Subsidy S <br />Part D subsidy enhanced service (ESI sends reports to CMS <br />$1.12 PMPM for Medicare -qualified Members <br />on behalf of Client) <br />with a minimum annual fee of $7,500 <br />i Notice of Creditable Coverage <br />$1.35/letter + postage <br />Part D Subsidy standard service (ESI sends reports to <br />$0.62 PMPM for Medicare -qualified Members <br />Client) <br />with a minimum annual fee of $5,000 <br />$1.35/letter + postage <br />A. Notice of Creditable Coverage <br />PBM Services – No Additional Fee <br />Customer service for Members <br />Electronic claims processing <br />Electronic/on-line eligibility submission <br />Plan seta <br />Standard coordination of benefits (COB) <br />reject for primary carrier <br />Software training for access to our on-line <br />system(s) <br />• FSA eligibility feeds <br />A. Network Pharmacy Services <br />Pharmacy help desk Pharmacy reimbursement <br />Pharmacy network management • Network development (upon request) <br />B. Home Delivery Services <br />Benefit education Prescription delivery – standard <br />• Reporting Services <br />• Web -based client reporting – • Annual Strategic Account Plan report <br />• Ad-hoc desktop parametric reports • Billing reports <br />• Claims detail extract file electronic (NCPDP format) • Inquiry access to claims processing <br />system <br />• Load 12 months claims history for clinical reports and <br />reporting <br />• Website Services <br />Express-Scripts.com for Members — access to benefit, <br />drug, health and wellness information; prescription ordering <br />capability; and customer service <br />