transaction), total dollar amount reported within Schedule A Income – Statement and payment/contract terms. For related party administrative service expenses, identify those expenses that are allocated to the contractor. For all allocated administrative service expenses, report whether the allocation is based on cost or cost plus. If cost plus, report the percentage above cost. From the list of transactions in Step 9a, select the three highest dollar amount transactions and one other random transaction. Note: include a series of transactions as one transaction for this selection. For the sample of transactions selected in Step 9b, recalculate the total dollar amount reported within Schedule A Income Statement based upon the – payment/contract terms of the agreement between the contractor and related party. List discrepancies and provide explanation for such contractor’s discrepancies. Schedule J - N: Lag Reports Given that the estimation of medical expenses and accruals is a key component to the accuracy of the amounts reported within the Income Statement, Schedules J N (Lag – Reports) are included within the agreed upon procedures. Step 1: Trace and agree the amounts paid for each (Total Paid by Month Column – AN) for the most recent 12 period ending December 31st. Trace and agree each monthly amount to the supporting documentation used by the contractor to complete each lag report. Provide explanation for contractor’s any discrepancies. Trace and agree each monthly amount to the monthly check register or claims system monthly summary. Provide explanation for any contractor’s discrepancies. Obtain representation from the management that medical cost is contractor’s reported net of third party liability (TPL) and coordination of benefits (COB). Provide explanation for any discrepancies. contractor’s Step 2: Trace and agree the amounts paid in the individual cells for the most recent 12 month incurral period ending December 31st. For the claims paid and incurred on Schedules J-N, trace and agree 4 cells from each lag report (a total of 20 cells) to the supporting documentation used by the contractor to complete the lag report. Provide explanation for any contractor’s discrepancies.
transaction), total dollar amount reported within Schedule A – Income Statement and payment/contract terms. For related party administrative service expenses, identify those expenses that are allocated to the contractor. For all allocated administrative service expenses, report whether the allocation is based on cost or cost plus. If cost plus, report the percentage above cost. From the list of transactions in Step 9a, select the three highest dollar amount transactions and one other random transaction. Note: include a series of transactions as one transaction for this selection. For the sample of transactions selected in Step 9b, recalculate the total dollar amount reported within Schedule A – Income Statement based upon the payment/contract terms of the agreement between the contractor and related party. List discrepancies and provide contractor’s explanation for such discrepancies. Schedule J - N: Lag Reports Given that the estimation of medical expenses and accruals is a key component to the accuracy of the amounts reported within the Income Statement, Schedules J – N (Lag Reports) are included within the agreed upon procedures. Step 1: Trace and agree the amounts paid for each (Total Paid by Month – Column AN) for the most recent 12 period ending December 31st. Trace and agree each monthly amount to the supporting documentation used by the contractor to complete each lag report. Provide contractor’s explanation for any discrepancies. Trace and agree each monthly amount to the monthly check register or claims system monthly summary. Provide contractor’s explanation for any discrepancies. Obtain representation from the contractor’s management that medical cost is reported net of third party liability (TPL) and coordination of benefits (COB). Provide contractor’s explanation for any discrepancies. Step 2: Trace and agree the amounts paid in the individual cells for the most recent 12 month incurral period ending December 31st. For the claims paid and incurred on Schedules J-N, trace and agree 4 cells from each lag report (a total of 20 cells) to the supporting documentation used by the contractor to complete the lag report. Provide contractor’s explanation for any discrepancies.
184_AUP_rev_2015-07-01_v3.docx