Laserfiche WebLink
� , � . <br /> EXHIBIT A <br /> CITY OF DECATUR <br /> "Administrator" Fees: <br /> Administration Services <br /> 11/1/01 — 10/31/02 $13.00 PEPM <br /> 11/1/02 — 10/31/03 $13.00 PEPM <br /> 11/1/03— 10/31/04 $14.95 PEPM* <br /> U/M Pre-Cert Fee 11/1/01 — 10/31/02 $ 3.00 PEPM ' <br /> 11/1/02 — 10/31/03 $ 3.00 PEPM <br /> 11/1/03 — 10/31/04 $ 3.00 PEPM <br /> PPO Access Fee 11/1/01 — 10/31/02 $ 3.50 PEPM <br /> 11/1/02 — 10/31/03 $ 3.50 PEPM <br /> 11/1/03— 10/31/04 $ 3.50 PEPM <br /> Initial Set-Up Fee $5,000.00 Payable upon effective Date <br /> Plus Printing Cost <br /> Reimbursement at <br /> the following rates: <br /> SPD $450 document <br /> Booklets $1.50 each copy <br /> I.D. Cards $1.75 each copy <br /> Run-In Claims Administration $9,466.60 Payable upon effective date <br /> Run-out Claims Administration The current in-force fee at time of <br /> termination payable by month for three <br /> (3) months, if the Plan elects for <br /> Consociate to process the run-out. <br /> Run-out administration fees are to be <br /> paid fully in advance of services.) <br /> * not to exceed <br /> "Administrator": City of Decatur Illinois <br /> Cons(qciate, Inc <br /> By: - � By: <br /> � City Manager <br /> Title: U , . Title: <br /> Date: /i� � � ���� � Date: October 29, 2ooi <br /> ATTEST: ��� <br /> ��� ��� ��� <br /> . � <br /> 13 City Clerk <br />