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<br />Consulting Services Agreement between City of San Leandro and June 1, 2017 Intercare Holdings Insurance Services, Inc Exhibit C – Page 1 of 3 <br />EXHIBIT B COMPENSATION SCHEDULE & REIMBURSABLE EXPENSES Annual Claims Administration Fee <br /> Annual Fee (1) Year 1 $97,400 Year 2 $100,322 Year 3 $103,332 <br />Total $301,054 (1) Fees shall increase annually by the greater of 3% as stated above or the percentage increase in the CPI for the twelve month period immediately preceding the contract anniversary date. The “Not To Exceed Fee “ shall be adjusted accordingly for the year. If agreement is renewed, the annual fee for Years 4 & 5 will increase by the greater of 3 % annually or the percentage increase in the CPI for the twelve month period immediately preceding the contract anniversary date. . <br />Bill Review Services1: <br />Per Bill Fee Inclusive of PPO Access <br /> $16.00 <br /> Flat Fee per Bill <br />PPO Network $0.00 Included in Flat Fee <br />Utilization Review Services1 <br />Level 1 – Adjuster Level No charge <br />Level 2 – Nurse $90.00 Per hour <br />Peer Review – Medical Director $200.00 Per hour <br />Specialty Peer Review6 $300.00 Per Hour <br />Case Management Services1 <br />Telephonic Case Management $90.00 Per Hour <br />Field Case Management - Pass through cost. Billed to claim file as incurred $105.00 Per Hour plus mileage <br />Transition Fee1 <br />Data Conversion $5,000.00 One-Time Fee <br />Implementation/Transition Cost No charge <br />SIU Services1 <br />• FD1–Fraud submission – Filing Fee for a complete package of SIU claim. Includes research, packaging and discussing with Department of Insurance. <br />$100.00 Per Case <br /> <br /> <br /> <br /> <br /> <br /> <br />76