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 State's 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 Date-stamp 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 State's 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: Date-stamp 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_FA2_EPO-SF.docx