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FIRST AMENDMENT TO THE UTILIZATION REVIEW AGREEMENT
DATED JANUARY 1, 1989
BETWEEN
HEALTHCARE COMPARE CORP.
AND
NATIONAL ASSOCIATION OF LETTER CARRIERS HEALTH BENEFIT PLAN
This AGREEMENT is entered as of this __ day of November, 1989, between
HealthCare COMPARE Corp. (hereinafter called "COMPARE"), and National
Association of Letter Carriers Health Benefit Plan (hereinafter called
"COMPANY").
WITNESSETH
WHEREAS, COMPARE AND COMPANY have heretofore entered into a certain
UTILIZATION REVIEW AGREEMENT, dated January 1, 1989, which provides for
utilization review services to be rendered to COMPANY,
WHEREAS, COMPARE and COMPANY desire to amend the Utilization Review Agreement
in the manner set out herein.
NOW, THEREFORE, in consideration of the mutual covenants and agreements set out
herein, one dollar and other good and valuable consideration, receipt of which
is hereby acknowledged, the parties hereto agree as follows:
A. Paragraph 4.B. of the Utilization Review Agreement is hereby amended to read
as follows:
B. The "base fee" set out in the Schedule of Fees is for the first year of this
Agreement. For each year after the first year of the term (the "Renewal
Year"), COMPARE shall have the right to increase the fee charged CARRIER.
Such base fee for Hospital Review Services shall not, without the specific
written approval of CARRIER, be increased over the base fee by more than
the lower of, i) the percentage of increase by which the Consumer Price
Index (CPI) on December 31 of the last preceding year exceeded the CPI from
December 31, 1988, or, ii) the annual percentage increase allowed by OPM in
establishing the administrative expense ceiling for the CARRIER applicable
to the Renewal Year. For the purposes of Subsection (i), the term "Consumer
Price Index" means the Consumer Price Index - U.S. City averages for Urban
Wage Earners and Clerical Workers, All Items, of the United States Bureau of
Labor Statistics (1982-l984 = 100). The Consumer Price Index for any year
shall be determined by averaging the
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monthly All Items Indices for that year. If the manner in which such
Consumer Price Index as determined by the Bureau of Labor Statistics shall
be substantially revised, an adjustment shall be made in such revised
index which would produce results equivalent, as nearly as possible, to
those which would have been obtained if the Consumer Price Index had not
been so revised. If the 1982-1984 average shall no longer be used as an
index of 100, such change shall constitute a substantial revision.
B. Parties hereby ratify and affirm the Utilization Review Agreement and agree
that it is in full force and effect and valid except as amended herein. This
Amendment shall prevail over any conflict with the Utilization Review
Agreement. In all respects the Utilization Review Agreement shall be
construed and interpreted to include all of the terms of this Amendment as
if the same were set out therein.
IN WITNESS WHEREOF the duly authorized representatives of the parties have
executed this Amendment as of the day and year first above written.
NATIONAL ASSOCIATION OF HEALTHCARE COMPARE CORP.
LETTER CARRIERS HEALTH
BENEFIT PLAN
By: Xxxxxxx X. Xxxxxxxxx By: Xxxxx X. Xxxxx
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President
Title: President
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