Common use of Services Charges Clause in Contracts

Services Charges. RMIS Additional Users (RMIS Standard License includes a set number of Full Access Users outlined under Administrative Services, and unlimited use of GB standard scheduled training classes) RMIS View-only User, $500 annually per user RMIS Full Access User, $1,000 annually per user Loss control $140 per hour OSHA Reporting $6,000, OSHA platform to produce compliant OSHA 301 Report, 300 and 300a Logs, and electronic data file. Oversight and accuracy of all OSHA data is responsibility of the employer prior to posting or submitting any OSHA log. Subrogation and Recovery 20% of net recovery amount less legal and collections expense based on recovery date Recoveries include subrogation, credits, lien waivers, file transfer (based on lien to date at time of transfer), and contribution or coverage handled in a separate action. Applies to all coverage types Special Fraud Investigations - SIU, Outside Field Investigations, Surveillance Investigations, Targeted Field Investigations Prevailing hourly rate plus expenses Targeted Database Searches, Self Service Database Searches Prevailing rate per report Invoice and Matter Management platform for adjusters/ counsel If utilized, 2% of net legal invoice (invoice net of disbursements and invoice review savings). Charged as discount off total payment remitted to counsel and will be reflected as an allocated expense on the claim file. 5 client licenses for Legal Analytics platform Attorney-led legal bill review Medicare Set-Aside Services: Allocation, CMS Submission, Medicare Eligibility Inquiry (MEI), SSDI Verification, Medical Cost Projection (MCP) Prevailing rate per each service Rush fees apply for MSA completed within 5 business days MSA Revision fees apply Medicare Secondary Payer Services: BCRC Notification, Conditional Payment Research (CPR), Conditional Payment Negotiations (CPN), Conditional Payment Notice Evaluation, Conditional Payment Dispute, Securing Final Demand for Settlement (SFD), Release / Settlement Agreement Review, Lien Research and Resolution (Advantage Plan, Medicaid, Part D) Prevailing rate per each service Taxes All applicable taxes will be added to the service fees where required

Services Charges. RMIS Additional Users (RMIS Standard License includes a set number of Full Access Users outlined under Administrative Services, and unlimited use of GB standard scheduled training classes) RMIS View-only User, $500 250 annually per user RMIS Full Access User, $1,000 500 annually per user Loss control $140 per hour OSHA Reporting $6,000, OSHA platform to produce compliant OSHA 301 Report, 300 and 300a Logs, and electronic data file. Oversight and accuracy of all OSHA data is responsibility of the employer prior to posting or submitting any OSHA log. Subrogation and Recovery 20% of net recovery amount less legal and collections expense based on recovery date Recoveries include subrogation, credits, lien waivers, file transfer (based on lien to date at time of transfer), and contribution or coverage handled in a separate action. Applies to all coverage Apxxxxx xx axx xxxxrage types Special Fraud Investigations - SIU, Outside Field Investigations, Surveillance Investigations, Targeted Field Investigations Prevailing hourly rate plus expenses Targeted Database Searches, Self Service Database Searches Prevailing rate Xxxxxxxxnx xxxx per report Invoice and Matter Management platform for adjusters/ counsel If utilized, 2% of net legal invoice (invoice net of disbursements and invoice review savings). Charged as discount off total payment remitted to counsel and will be reflected as an allocated expense on the claim file. 5 client licenses for Legal Analytics platform Attorneyxxxxform Attxxxxx-led legal bill xxx xxxxx xill review Medicare Set-Aside Services: Allocation, CMS Submission, Medicare Eligibility Inquiry (MEI), SSDI Verification, Medical Cost Projection (MCP) Prevailing rate per each service Rush fees apply for MSA completed within 5 business days MSA Revision fees apply Medicare Secondary Payer Services: BCRC Notification, Conditional Payment Research (CPR), Conditional Payment Negotiations (CPN), Conditional Payment Notice Evaluation, Conditional Payment Dispute, Securing Final Demand for Settlement (SFD), Release / Settlement Agreement Review, Lien Research and Resolution (Advantage Plan, Medicaid, Part D) Prevailing rate per each service Taxes All applicable taxes will be added to the service fees where required

Services Charges. RMIS Additional Users (RMIS Standard License includes a set number of Full Access Users outlined under Administrative Services, and unlimited use of GB standard scheduled training classes) RMIS View-only User, $500 250 annually per user RMIS Full Access User, $1,000 500 annually per user Loss control $140 per hour OSHA Reporting $6,000, OSHA platform to produce compliant OSHA 301 Report, 300 and 300a Logs, and electronic data file. Oversight and accuracy of all OSHA data is responsibility of the employer prior to posting or submitting any OSHA log. Subrogation and Recovery 20% of net recovery amount less legal and collections expense based on recovery date Recoveries include subrogation, credits, lien waivers, file transfer (based on lien to date at time of transfer), and contribution or coverage handled in a separate action. Applies to all coverage types Special Fraud Investigations - SIU, Outside Field Investigations, Surveillance Investigations, Targeted Field Investigations Prevailing hourly rate plus expenses Targeted Database Searches, Self Service Database Searches Prevailing rate per report Invoice and Matter Management platform for adjusters/ counsel If utilized, 2% of net legal invoice (invoice net of disbursements and invoice review savings). Charged as discount off total payment remitted to counsel and will be reflected as an allocated expense on the claim file. 5 client licenses for Legal Analytics platform Attorney-led legal bill review Medicare Set-Aside Services: Allocation, CMS Submission, Medicare Eligibility Inquiry (MEI), SSDI Verification, Medical Cost Projection (MCP) Prevailing rate per each service Rush fees apply for MSA completed within 5 business days MSA Revision fees apply Medicare Secondary Payer Services: BCRC Notification, Conditional Payment Research (CPR), Conditional Payment Negotiations (CPN), Conditional Payment Notice Evaluation, Conditional Payment Dispute, Securing Final Demand for Settlement (SFD), Release / Settlement Agreement Review, Lien Research and Resolution (Advantage Plan, Medicaid, Part D) Prevailing rate per each service Taxes All applicable taxes will be added to the service fees where required

Services Charges. RMIS Additional Users (RMIS Standard License includes a set number of Full Access Users outlined under Administrative Services, and unlimited use of GB standard scheduled training classes) RMIS View-only User, $500 annually per user RMIS Full Access User, $1,000 annually per user Loss control $140 per hour OSHA Reporting $6,000, OSHA platform to produce compliant OSHA 301 Report, 300 and 300a Logs, and electronic data file. Oversight and accuracy of all OSHA data is responsibility of the employer prior to posting or submitting any OSHA log. Subrogation and Recovery 20% of net recovery amount less legal and collections expense based on recovery date Recoveries include subrogation, credits, lien waivers, file transfer (based on lien to date at time of transfer), and contribution or coverage handled in a separate action. Applies to all coverage types Special Fraud Investigations - SIU, Outside Field Investigations, Surveillance Investigations, Targeted Field Investigations Prevailing hourly rate plus expenses Targeted Database Searches, Self Service Database Searches Prevailing rate per report Invoice and Matter Management platform for adjusters/ adjusters/counsel If utilized, 2% of net legal invoice (invoice net of disbursements and invoice review savings). Charged as discount off total payment remitted to counsel and will be reflected as an allocated expense on the claim file. 5 client licenses for Legal Analytics platform Attorney-led legal bill review Medicare Set-Aside Services: Allocation, CMS Submission, Medicare Eligibility Inquiry (MEI), SSDI Verification, Medical Cost Projection (MCP) Prevailing rate per each service Rush fees apply for MSA completed within 5 business days MSA Revision fees apply Medicare Secondary Payer Services: BCRC Notification, Conditional Payment Research (CPR), Conditional Payment Negotiations (CPN), Conditional Payment Notice Evaluation, Conditional Payment Dispute, Securing Final Demand for Settlement (SFD), Release / Settlement Agreement Review, Lien Research and Resolution (Advantage Plan, Medicaid, Part D) Prevailing rate per each service Taxes All applicable taxes will be added to the service fees where required