Finance Committee

CITY OF NASHUA

Definitions. For purposes of this Schedule C, the following terms have the following meanings:

Average Wholesale Price or AWP shall mean the price of a prescription drug dispensed as established and reported
by MediSpan, First DataBank, or other nationally recognized pricing source selected by PBM in its sole discretion
from time to time. AWP does not represent a true wholesale price, but rather is a fluctuating benchmark provided by
third party pricing sources.

Network Drug Pricing Guarantee

Network Drug Pricing Guarantees - Pharmacy Reimbursement Rates

Retail Pharmacy Network Drug Pricing Guarantees and Conditions. The Net Effective Reimbursement Rates for
network retail pharmacies will be subject to the following annual "Retail Network Guarantees":

|. Brand Discount Off AWP: 14.50%
2. Brand Dispensing Fee: $1.40

3. Generic Discount Off AWP: 70.0%
4. Generic Dispensing Fee: $1.40

The Retail Pharmacy Network Guarantees shall be subject to the following conditions:

Performance
Category
First Call
Resolution

Amount at
Risk

Year 1:
$20,000.00

Guarantee

Performance
Category
Average Speed
to Answer

Call
Abandonment
Rate

Amount at
Risk

Year 1:
$20,000.00

Year1:

$20,000.00

Guarantee

This Attachment is made part

ATTACHMENT TO SCHEDULE C
Performance Guarantees
TO ADMINISTRATIVE SERVICES AGREEMENT

WITH
CITY OF NASHUA

Performance Guarantees

of Schedule C and will be effective for the Performance Period from July 1, 2013
through June 30, 2014. This Attachment is intended to supplement and amend the Agreement between the Parties.

Operations Performance Guarantees

Performance
Category
Implementation

Survey

Amount at
Risk
Year 1:

$20,000.00

Payment

For the purposes of calculating compliance with the Performance Guarantees contained in the
Attachments to this Schedule C, if a delay in performance of, or inability to perform, a service underlying
any of the Performance Guarantees is due to circumstances which are beyond the control of Anthem,
including but not limited to any act of God, civil riot, floods, fire, acts of terrorists, acts of war terrorism or,
power outage, such delayed or non-performed service will not count towards the measurement of the
applicable Performance Guarantee.

SCHEDULE C
TO
ADMINISTRATIVE SERVICES AGREEMENT
WITH
City of Nashua

* Healthy Solutions Newsletter (available online)
+ MyHealth (Member Portal)
- Electronic Health Risk Assessment
- Personal Health Record
- Online Communities
- Member Alerts
* 360° Health Services (HMO/POS Plans)
* ConditionCare
- Asthma
- Pulmonary disease
- Congestive heart failure
- Coronary artery disease
- Diabetes
* Future Moms

* ComplexCare

* 24/7 NurseLine

Networks
» Access to networks

- Provider Network

- Mental Health/Substance Abuse Network

¢« Member customer service, standard business hours
* 1099s prepared and delivered to Providers
* Residency-based assessments and/or surcharges and other legislative reporting requirements

* Member eServices

Prescription Benefit Services
* Mail Order pharmacy
* Specialty Pharmacy Services
* Prescription eServices

- Pharmacy locator
- Online formulary

* Point of sale claims processing

* Mail order claims processing

* Mail order call center with toll free number

« Mail order regular shipping and handling