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• <br />3. Peidpg. Thr fman"ftosl set forth are cor dftt►cd on suets arrangement and 411 <br />conditions set forth in xhibitt A ofthe Agreement. Client will pay to A�t r the amounts sbeIOWj=t.} " <br />ofappiicable Copayments. The application of brand and generic alkw. be subject to certain "dispensed: <br />as written" (DAW) protocols and Client defined plan design and coveil009 V".4cies for adjudication and Member <br />Copayment purposes. Sales or excise tax or other governmental surchargN A& be the responsibility of Client. <br />Members will always pay based on the logic below: <br />0—INA. Ir <br />.... a..J�'r.� .fie r"rA/. �::w. ;k:bllw - ...�...�r:..:..,r�rti. .w I�SZL.rdJi i►v.u�rw..f^� <br />rod ad 11 f -Appos6 —LVM i3W!ti. a jaiij <br />$0.00 per review+'t' 1 CI i <br />t, SW Ate* .. <br />review fees above) <br />%ovol;Qw ig'tr i+[th onlj+ one level 44% <br />* this additional fee is applied to each initial <br />'► ties be i rgent at Level One or IA" id iq1 <br />determination. <br />aWdt t 8 ttmgnal and binding <br />pe rg <br />o by Independent Review O anima <br />t?iM�11»' <br />fora adfathered Tans <br />Comprehensive Consumer Driven Health (C <br />Sflhttion <br />Consumer t toffee flan <br />All ser0d JW Plti <br />Technical <br />Technical and Member Advocacy -..,VZ" <br />$i-direcdoW data exchange; dedicated operations; 24- <br />Health Choices and Drug Choices:: <br />hour a day, seven -days a week monitoring and quality <br />corttt4laMt performancereporting; and analytics <br />"these charges would be in addition to any pricing <br />Dedicated CDH member services, open enrollment tools <br />adjustments if greater than ten percent of Client's total <br />and member communications library, robust online <br />utilization for all Pians is attributable to a CDHC. <br />features, fast preventive care <br />Health Choices <br />Medication Adherence Monitoring andOwreach and <br />proactive, personalind member commupications <br />Drug Choices <br />Benefit Coaching, Prescription Benefit Review <br />Statements, proactive, personalized member <br />communications <br />Medicare Part D — Retiree Drug SuWid <br />Part D subsidy enhanced servio (ESI sends reports to <br />.11:111*10M for Medicare -qualified Metmbox svitt a.. <br />CMS on behalf of Client)tlnr►uai <br />fee of $7,500 <br />i Notice of gred liblepum+p2stage <br />Part D Subsidy standard f " t31$OAVJWV-Jbr <br />Medicare -qualified Members,*** <br />Client) <br />tlptutal fee of $5,000 <br />A, <br />3. Peidpg. Thr fman"ftosl set forth are cor dftt►cd on suets arrangement and 411 <br />conditions set forth in xhibitt A ofthe Agreement. Client will pay to A�t r the amounts sbeIOWj=t.} " <br />ofappiicable Copayments. The application of brand and generic alkw. be subject to certain "dispensed: <br />as written" (DAW) protocols and Client defined plan design and coveil009 V".4cies for adjudication and Member <br />Copayment purposes. Sales or excise tax or other governmental surchargN A& be the responsibility of Client. <br />Members will always pay based on the logic below: <br />0—INA. Ir <br />.... a..J�'r.� .fie r"rA/. �::w. ;k:bllw - ...�...�r:..:..,r�rti. .w I�SZL.rdJi i►v.u�rw..f^� <br />