FORM# PS_A0O14
Reports.
(a)
(b)
(d)
(a)
(a)
HPHC shall assist Purchaser, upon Purchaser’s request, in
providing such reports as may be required by any regulatory agency
having jurisdiction over the operations of the Plan including, to the
extent applicable, the U.S. Department of Labor (including Form
5500 and Summary Annual Report), the Internal Revenue Service,
and state governmental agencies. HPHC shall, upon Purchaser's
request, comply on Purchaser's behalf, with the New York Health
Care Reform Act reporting requirements.
HPHC shall report, at Purchaser's request, concerning the activities
of the Plan as shall be reasonably necessary for Purchaser, its
officers and directors, to fulfill their corporate or governmental
responsibilities.
HPHG shall provide reports to Purchaser, upon Purchaser’s request ”
on a schedule as indicated below:
HPHC will provide reinsurance notifications and filings as outlined in
the HPHC Reinsurance Guidelines to the reinsurance carrier as
noted in the Purchaser’s Stop Loss Policy (Attachment G). HPHC
will accommodate non standard requests subject to available
capacity and will reserve the right to charge one hundred dollars
($100.00) per hour for labor costs and a set up fee of one hundred
dollars ($100) per hour for programming costs and seventy-five
dollars ($75.00) per hour for installation costs associated with each
request.
Monthly
A monthly paid claims report including member identification
number, incurred date or date of service, service paid date/monih,
type of claims (hospital, medical or drug), type of service
description, provider number, total amount paid. All claims, including
prescription drug claims, shail be included. This report shall be
provided in an accepted electronic media format to the Purchaser or
its Designee, which acceptance shall not be unreasonably withheld,
Quarterly
On a quarterly basis or when reasonably requested by Purchaser,
HPHC shall furnish Purchaser with reports regarding the utilization
and cost of health services and supplies rendered to Members by
providers of these services. Such reports shall include, but not be
limited to, eligibility data and information regarding the types and
costs of services rendered and the frequency with which each type
of service was performed. HPHC will accommodate non standard
requests subject to available staffing capacity and will reserve the
right to charge one hundred dollars ($100) per hour for labor costs
05/17/2002
