Performance Standards Penalties Enrollment File: The CONTRACTOR must accept an enrollment file update on a daily basis and accurately process the enrollment file additions, changes, and deletions within two (2) BUSINESS DAYS of the file receipt. Delays in processing the 834 file must be communicated to the DEPARTMENT Program Manager or designee within one (1) BUSINESS DAY. See One thousand Enrollment Discrepancies: The CONTRACTOR must resolve all ($1,000) dollars per enrollment discrepancies (any difference of values between the DAY for which the standard is not met database and the database) as DEPARTMENT’S CONTRACTOR’s identified within one (1) BUSINESS DAY of notification by the DEPARTMENT or identification by the CONTRACTOR. See . ID CARDS: The CONTRACTOR shall issue ID CARDS within five (5) BUSINESS DAYS of the generation date of the enrollment file containing the addition or enrollment change, except as noted in item 4) below. See , 1. ID CARDS for elections made during the IT’S YOUR CHOICE OPEN ENROLLMENT Period: The CONTRACTOR shall issue ID One thousand ($1,000) dollars per CARDS by December 15 for enrollment additions or changes DAY for which the effective the following January 1 calendar year, as submitted on standard is not met enrollment files generated on the first DAY of the IT’S YOUR CHOICE OPEN ENROLLMENT period through December 10. See , 2. 315G Other The total penalties for this performance category shall not exceed three (3%) percent of the total administrative fee for the quarter. Performance Standards Penalties Audit: The CONTRACTOR shall address any areas of improvement as identified in the audit in the timeframe as determined by the DEPARTMENT One thousand ($1,000) dollars per Grievance Resolution: Investigation and resolution of any DAY for which the grievance will be initiated within five (5) BUSINESS DAYS of the standard is not met date the grievance is filed by the complainant for a timely resolution of the problem. Grievances related to an urgent health concern will be handled within seventy-two (72) hours of the CONTRACTOR'S receipt of the grievance. Major System Changes and Conversions: The CONTRACTOR One thousand shall verify and commit that during the length of the contract, it shall ($1,000) dollars per DAY for which the not undertake a major system change or conversion for, or related standard is not met to, the system used to deliver services for the HEALTH BENEFIT
Performance Standards Penalties Enrollment File: The CONTRACTOR must accept an enrollment file update on a daily basis and accurately process the enrollment file additions, changes, and deletions within two (2) BUSINESS DAYS of the file receipt. Delays in processing the 834 file must be communicated to the DEPARTMENT Program Manager or designee within one (1) BUSINESS DAY. See One thousand ($1,000) dollars per DAY for which the standard is not met Enrollment Discrepancies: The CONTRACTOR must resolve all enrollment discrepancies (any difference of values between the DEPARTMENT’S database and the CONTRACTOR’s database) as identified within one (1) BUSINESS DAY of notification by the DEPARTMENT or identification by the CONTRACTOR. See . ID CARDS: The CONTRACTOR shall issue ID CARDS within five (5) BUSINESS DAYS of the generation date of the enrollment file containing the addition or enrollment change, except as noted in item 4) below. See , 1. ID CARDS for elections made during the IT’S YOUR CHOICE OPEN ENROLLMENT Period: The CONTRACTOR shall issue ID CARDS by December 15 for enrollment additions or changes effective the following January 1 calendar year, as submitted on enrollment files generated on the first DAY of the IT’S YOUR CHOICE OPEN ENROLLMENT period through December 10. See , 2. One thousand ($1,000) dollars per DAY for which the standard is not met 315G Other The total penalties for this performance category shall not exceed three (3%) percent of the total administrative fee for the quarter. Performance Standards Penalties Audit: The CONTRACTOR shall address any areas of improvement as identified in the audit in the timeframe as determined by the DEPARTMENT One thousand ($1,000) dollars per DAY for which the standard is not met Grievance Resolution: Investigation and resolution of any grievance will be initiated within five (5) BUSINESS DAYS of the date the grievance is filed by the complainant for a timely resolution of the problem. Grievances related to an urgent health concern will be handled within seventy-two (72) hours of the CONTRACTOR'S receipt of the grievance. Major System Changes and Conversions: The CONTRACTOR shall verify and commit that during the length of the contract, it shall not undertake a major system change or conversion for, or related to, the system used to deliver services for the HEALTH BENEFIT One thousand ($1,000) dollars per DAY for which the standard is not met
Exhibit1_PBP_Agreement_Rev.docx