Table 7.1 Experience Managing Self-funded PPOs If Number “yes,” Services Self-Insured Plan Number of Public or Number of Year Year of lives Provided Client Name Plan Type* Member WA Private Covered Began Ended within an and Contact (Limit of 15 Geography** Counties Sector Plan Lives Services Services ACN? Information services) Served (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) *Please select a Plan Type from the following: Self-Funded PPO, Fully-Insured PPO. **List the number of Members (A) within Washington State, (B) outside Washington State (indicate state(s)), and (C) outside the United States.
Table 7.1 Experience Managing Self-funded PPOs Self-Insured Client Name and Contact Information Plan Type* Plan Member Geography** If “yes,” Number of WA Counties Served Public or Private Sector Plan Number of Covered Lives Services Provided (Limit of 15 services) Year Began Services Year Ended Services Number of lives within an ACN? (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) (A) (B) (C) *Please select a Plan Type from the following: Self-Funded PPO, Fully-Insured PPO. **List the number of Members (A) within Washington State, (B) outside Washington State (indicate state(s)), and (C) outside the United States.