appearance and behavior. Time over which standard is measured: Annual Delivery of Delivery to the State by Documentation of 0.20% of fees for Quarterly 6:00PM on the receipt by State's each week, or Utilization, Case following dates**: Benefit Consultant, fraction thereof, Management, and First Quarter i.e., date-stamp of the data report is Disease mailing package for not received or is (Jan Mar) – Management Data data information incomplete. Due: May 1st Reports to and verification of Second Quarter Consultant completeness. (All (Apr Jun) – required fields Due: August 1st must be filled in Third Quarter correctly.) (Jul Sep) – Due: November 1st Frequency of Fourth Quarter report: Quarterly (Oct Dec) – Due: February 1st Delivery of Rate Delivery to the State of Renewal Reports and to the State's receipt by the actuarial consultant of State and reports required for verification of annual rate renewal completeness of process by 6:00PM required March 1 of each documentation. contract year. At a Frequency of minimum, the renewal report: Annually reports must include (but not be limited to) the following: Projection of incurred claim costs for renewal year. Estimate of IBNR reserves at end of current year; including the most recent 36 months of incurred/paid triangular reports. Complete documentation of the methodology and assumptions utilized to
appearance and behavior. Time over which standard is measured: Annual Delivery of Quarterly Utilization, Case Management, and Disease Management Data Reports to Consultant Delivery to the State by 6:00PM on the following dates**: Documentation of receipt by State's Benefit Consultant, i.e., date-stamp of mailing package for data information and verification of completeness. (All required fields must be filled in correctly.) Frequency of report: Quarterly 0.20% of fees for each week, or fraction thereof, the data report is not received or is incomplete. First Quarter (Jan – Mar) Due: May 1st Second Quarter (Apr – Jun) Due: August 1st Third Quarter (Jul – Sep) Due: November 1st Fourth Quarter (Oct – Dec) Due: February 1st Delivery of Rate Renewal Reports Delivery to the State and to the State's actuarial consultant of reports required for annual rate renewal process by 6:00PM March 1 of each contract year. At a minimum, the renewal reports must include (but not be limited to) the following: of receipt by the State and verification of completeness of required documentation. Frequency of report: Annually Projection of incurred claim costs for renewal year. Estimate of IBNR reserves at end of current year; including the most recent 36 months of incurred/paid triangular reports. Complete documentation of the methodology and assumptions utilized to
SLEOLAMedical_FA3_POS-SF.docx