Common use of Administrative and Other Charges Clause in Contracts

Administrative and Other Charges. a. Plan Administrator will pay to HEBP the Administrative Charges specified in this Agreement within ten (10) days of the first day of each Month. Administrative Charges will be paid based upon enrollment information HEBP receives regarding current enrollment as of the first day of each Month. Appropriate adjustments will be made for enrollment variances. HEBP shall provide notification regarding any discrepancies. b. Pharmacy Benefit Management Fees are assessed and collected per prescription filled. c. HEBP reserves the right to change the Administrative Charge if a substantial change occurs in the number or composition of employees covered, which results from: 1). A change in the benefit specifications provided under the contract; or 2). A change in the Member’s contribution level or other consideration paid by the Member if it results in a decrease in participation; or 3). A substantial change in the number of Subscribers covered under this contract. A substantial change would be deemed to have occurred when the number of employees covered changes by: i) 10% or more over a 30 day period; or ii) 25% or more over a 90 day period. In such event, HEBP reserves the right to adjust the rates on any due date occurring between the date such substantial change is identified and the next Fee Schedule period. A rate increase under this provision may not exceed 10%. d. Additional charges may be imposed if: 1). Either HEBP or Member files for bankruptcy or reorganization under state or federal law. 2). The Administrative Charge becomes subject to premium tax. Any Administrative Charges shall automatically be increased by the amount of any taxes imposed, increased, or adjudged due by any lawful authority on or after the contract date, which HEBP is required to pay or remit, whether relating to fees, services, benefits, payments, or any other aspect of this contract. 3). Future changes mandated by legislation or other law result in an increase in cost to HEBP in performing under this Agreement. e. In addition to the Administrative Charge, Plan Administrator shall reimburse HEBP for the direct cost of special or customized supplies, reports, forms, or other services provided by HEBP for Plan Administrator and indicated in the Fee Schedule. Reimbursement of charges for additional services will be limited to those mutually agreed upon by Plan Administrator and HEBP before HEBP incurs the cost of such services. f. In addition to the amounts due and payable each Month, HEBP may charge Plan Administrator for: 1). Reasonable fees for the reproduction or return of Records requested by Plan Administrator, a governmental agency, or pursuant to a court order; and 2). Any other fees that may be assessed by third parties for services rendered to the Plan Administrator and/or any other fees for services mutually agreed upon by the parties, as shown in Item Three of the Fee Schedule. g. Performance of all duties and obligations of HEBP under this Agreement are contingent upon the payment of Administrative Charges in accordance with Section 3.05a of this Agreement.

Administrative and Other Charges. a. Plan Administrator will pay to HEBP the Administrative Charges specified in this Agreement within ten thirty (1030) days of the first day receipt of each Monththe billing statement (or forty-five (45) days of receipt in a political subdivision whose governing body meets only once a month or less frequently). Administrative Charges will be paid based upon enrollment information HEBP receives regarding current enrollment as of the first day of each Month. Appropriate adjustments will be made for enrollment variances. HEBP shall provide notification regarding any discrepancies. b. Pharmacy Benefit Management Fees are assessed and collected per prescription filled. c. HEBP reserves the right to change the Administrative Charge if a substantial change occurs in the number or composition of employees covered, which results from: 1). A change in the benefit specifications provided under the contract; or 2). A change in the Member’s contribution level or other consideration paid by the Member if it results in a decrease in participation; or 3). A substantial change in the number of Subscribers covered under this contract. A substantial change would be deemed to have occurred when the number of employees covered changes by: i) 10% or more over a 30 day period; or ii) 25% or more over a 90 day period. In such event, HEBP reserves the right to adjust the rates on any due date occurring between the date such substantial change is identified and the next Fee Schedule period. A rate increase under this provision may not exceed 10%. d. Additional charges may be imposed if: 1). Either HEBP or Member files for bankruptcy or reorganization under state or federal law. 2). The Administrative Charge becomes subject to premium tax. Any Administrative Charges shall automatically be increased by the amount of any taxes imposed, increased, or adjudged due by any lawful authority on or after the contract date, which HEBP is required to pay or remit, whether relating to fees, services, benefits, payments, or any other aspect of this contract. 3). Future changes mandated by legislation or other law result in an increase in cost to HEBP in performing under this Agreement. e. In addition to the Administrative Charge, Plan Administrator shall reimburse HEBP for the direct cost of special or customized supplies, reports, forms, or other services provided by HEBP for Plan Administrator and indicated in the Fee Schedule. Reimbursement of charges for additional services will be limited to those mutually agreed upon by Plan Administrator and HEBP before HEBP incurs the cost of such services. f. In addition to the amounts due and payable each Month, HEBP may charge Plan Administrator for: 1). Reasonable fees for the reproduction or return of Records requested by Plan Administrator, a governmental agency, or pursuant to a court order; and 2). Any other fees that may be assessed by third parties for services rendered to the Plan Administrator and/or any other fees for services mutually agreed upon by the parties, as shown in Item Three of the Fee Schedule. g. Performance of all duties and obligations of HEBP under this Agreement are contingent upon the payment of Administrative Charges in accordance with Section 3.05a of this Agreement.

Administrative and Other Charges. a. Plan Administrator will pay to HEBP the Administrative Charges specified in this Agreement within ten (10) days of the first day of each Monthmonth. Administrative Charges will be paid based upon enrollment information HEBP receives regarding current enrollment as of the first day of each Month. Appropriate adjustments will be made for enrollment variances. HEBP shall provide notification regarding any discrepancies. b. Pharmacy Benefit Management Fees are assessed and collected per prescription filled. c. HEBP reserves the right to change the Administrative Charge if a substantial change occurs in the number or composition of employees covered, which results from: 1). A change in the benefit specifications provided under the contract; or 2). A change in the Member’s contribution level or other consideration paid by the Member if it results in a decrease in participation; or 3). A substantial change in the number of Subscribers covered under this contract. A substantial change would be deemed to have occurred when the number of employees covered changes by: i) i. 10% or more over a 30 day period; or ii) . 25% or more over a 90 day period. In such event, HEBP reserves the right to adjust the rates on any due date occurring between the date such substantial change is identified and the next Fee Schedule period. A rate increase under this provision may not exceed 10%. d. Additional charges may be imposed if: 1). Either HEBP or Member files for bankruptcy or reorganization under state or federal law. 2). The Administrative Charge becomes subject to premium tax. Any Administrative Charges shall automatically be increased by the amount of any taxes imposed, increased, or adjudged due by any lawful authority on or after the contract date, which HEBP is required to pay or remit, whether relating to fees, services, benefits, payments, or any other aspect of this contract. 3). Future changes mandated by legislation or other law result in an increase in cost to HEBP in performing under this Agreement. e. In addition to the Administrative Charge, Plan Administrator shall reimburse HEBP for the direct cost of special or customized supplies, reports, forms, or other services provided by HEBP for Plan Administrator and indicated in the most current Fee Schedule. Reimbursement of charges for additional services will be limited to those mutually agreed upon by Plan Administrator and HEBP before HEBP incurs the cost of such services. f. In addition to the amounts due and payable each Month, HEBP may charge Plan Administrator for: 1). Reasonable fees for the reproduction or return of Records requested by Plan Administrator, a governmental agency, or pursuant to a court order; and 2). Any other fees that may be assessed by third parties for services rendered to the Plan Administrator and/or any other fees for services mutually agreed upon by the parties, as shown in Item Three of the most current Fee Schedule. g. Performance of all duties and obligations of HEBP under this Agreement are contingent upon the payment of Administrative Charges in accordance with Section 3.05a of this Agreement.

Administrative and Other Charges. a. Plan Administrator will pay to HEBP the Administrative Charges specified in this Agreement within ten (10) days of the first day of each Month. Administrative Charges will be paid based upon enrollment information HEBP receives regarding current enrollment as of the first day of each Month. Appropriate adjustments will be made for enrollment variances. HEBP shall provide notification regarding any discrepancies. b. Pharmacy Benefit Management Fees are assessed and collected per prescription filled.. Draft c. HEBP reserves the right to change the Administrative Charge if a substantial change occurs in the number or composition of employees covered, which results from: 1). A change in the benefit specifications provided under the contract; or 2). A change in the Member’s contribution level or other consideration paid by the Member if it results in a decrease in participation; or 3). A substantial change in the number of Subscribers covered under this contract. A substantial change would be deemed to have occurred when the number of employees covered changes by: i) 10% or more over a 30 day period; or ii) 25% or more over a 90 day period. In such event, HEBP reserves the right to adjust the rates on any due date occurring between the date such substantial change is identified and the next Fee Schedule period. A rate increase under this provision may not exceed 10%. d. Additional charges may be imposed if: 1). Either HEBP or Member files for bankruptcy or reorganization under state or federal law. 2). The Administrative Charge becomes subject to premium tax. Any Administrative Charges shall automatically be increased by the amount of any taxes imposed, increased, or adjudged due by any lawful authority on or after the contract date, which HEBP is required to pay or remit, whether relating to fees, services, benefits, payments, or any other aspect of this contract. 3). Future changes mandated by legislation or other law result in an increase in cost to HEBP in performing under this Agreement. e. In addition to the Administrative Charge, Plan Administrator shall reimburse HEBP for the direct cost of special or customized supplies, reports, forms, or other services provided by HEBP for Plan Administrator and indicated in the Fee Schedule. Reimbursement of charges for additional services will be limited to those mutually agreed upon by Plan Administrator and HEBP before HEBP incurs the cost of such services. f. In addition to the amounts due and payable each Month, HEBP may charge Plan Administrator for:: Draft 1). Reasonable fees for the reproduction or return of Records requested by Plan Administrator, a governmental agency, or pursuant to a court order; and 2). Any other fees that may be assessed by third parties for services rendered to the Plan Administrator and/or any other fees for services mutually agreed upon by the parties, as shown in Item Three of the Fee Schedule. g. Performance of all duties and obligations of HEBP under this Agreement are contingent upon the payment of Administrative Charges in accordance with Section 3.05a of this Agreement.