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SCHEDULE C <br />FEE SCHEDULE <br />One -Time Implementation Fees <br />• Plan Documents & Summary Plan Descriptions <br />• Enrollment Materials <br />• Plan Installation <br />• Implementation of Clarity Quick Claim <br />• Web Based Enrollment Service <br />Implementation Fee <br />Debit Card per Participant <br />Administration Services <br />• Process Debit Card Transactions <br />• Review and Process Claims <br />• Integrate with insurance Carriers <br />• Process Reimbursement Checks and Direct Deposit <br />• Provide Plan Reports <br />• Provide Mobile, Online and Text communication of Plan Data <br />Annually <br />• Annual Renewal Fee (Consumer Benefits Only) <br />Monthly Fees <br />Retiree Billing Per Participant Fee <br />Optional Services <br />Next Day Delivery <br />Banking/Misc. Fees <br />NSF Fee <br />Stop Payment <br />ACH Rejects <br />860520 <br />11.2.2016 <br />$0.00 <br />NIA <br />Waived <br />$2.50 <br />$35.00 <br />$50.00 <br />$25.00 <br />$25.00 <br />