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DocuSign Envelope ID: 5332467E-CBEF-4C5D-8BOE-61 E380BDAl 1 B <br />DocuSign Envelope ID: 151ECOCF-855C-414F-9455-72004347A310 <br />(112023 Version) <br />C. SERVICES, FORMULARY. PRICING GUARANTEES. <br />Base Administrative Services. The following services are the base administrative services made available <br />to Client and its Members pursuant to the Agreement (including this Exhibit A) (the "Base Administrative <br />Services"), as applicable: <br />• Administration of eligibility submitted via telecommunication or electronically <br />• Eligibility maintenance <br />• Client support system for on-line access to current eligibility <br />• Administration of Client's Plan Design <br />• In -network claims adjudication via on-line claims adjudication system <br />• Designated Account Team <br />• Client clinical and plan consulting, analysis and cost projections <br />• Annual analysis of program utilization and impact of plan design and managed care <br />interventions <br />• Welcome Package and 1 D Cards (hard copy or digital) for new Members <br />• Standard Member communications <br />• Toll-free telephone access to customer service for the program for use by Members and Client's <br />benefits personnel and representatives <br />2. Additional Administrative Services. Client will pay for additional administrative services (the "Additional <br />Administrative Services") beyond those included in the Base Administrative Services that are requested by <br />Client and provided or made available by Administrator under the program as follows: <br />2.1 Transaction Fees <br />LU <br />Transaction Fees Payable for Administrative Services (per <br />$0.65 per Prescription Drug Claim made by <br />Article I V.B of the Agreement <br />Members payable on a bi-monthly basis <br />Transaction Fees Payable for Administrator's Protect <br />Program <br />(individual prices listed in table below) <br />• Indian River County Board of County <br />$1.25 per claim <br />Commissioners Clinical -All Plans -Remove <br />MCAP SaveOnSP fee <br />ProgramsManufacturer Copay Assistance <br />• Out of Pocket Protection (Accumulation) <br />• Indian River County Board of County <br />Not Elected <br />Commissioners Clinical -All Plans -Remove <br />MCAP SaveOnSP fee <br />• Out of Pocket Protection + Variable Copay <br />Assistance Program <br />• Indian River County Board of County <br />Not Elected <br />Commissioners Clinical -All Plans -Remove <br />MCAD SaveOnSP fee <br />• SaveOnSP <br />• Indian River County Board of County <br />Not Elected <br />Commissioners Clinical -All Plans -Remove <br />MCAD SaveOnSP fee <br />• Out of Pocket Protection + SaveOnSP <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED IIEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />