INNOVATIVE CLAIM SOLUTIONS (ICS)

all PPO savings, 20% of savings on all non PPO inpatient hospital bill savings and 16%of all non PPO outpatient bill savings, unless otherwise negotiated. 3. Use and cooperate fully with the designated Utilization Review vendor to refer all cases that meet the requirements of this service, for purposes of controlling treatment parameters and duration in accordance with all legislative changes. 4. Unless otherwise directed, ICS will select the Utilization Review service provider to be utilized and the CLIENT will pay for such services. The rate for utilization review services will be charged at$100 per RN determination, $220 per hour(billed in 1/ 4 hour increments) for all Physician Adviser Reviews, $310 per hour(billed in 1/4 hour increments) for all Specialty Physician Reviews on appeal and all Peer Reviews. G. Information Systems - ICS will provide a computer system with appropriate data base management capabilities to maintain records related to the administration of the CLIENT'S workers' compensation program. ICS shall coordinate data entry for employees in the program and for services supplied by ICS. The CLIENT shall have access to the computer system during normal working hours and access to the database through its own computers at its own expense. ICS shall provide computer-generated reports that are reasonably requested on a regular basis as detailed in section H below. H. Statistical. ICS will adhere to the following statistical report production obligations and provide all required reports to the CLIENT at agreed to intervals: 1. Report to CLIENT,monthly status of claim payments and reserves on an individual claim basis and in the aggregate. 2. Report to CLIENT, quarterly loss analysis of claims filed by frequency and severity. 3. Assist in the preparation of all reports required by the State of California or other Governmental agencies relating to Workers' Compensation claims. 4. ICS will prepare the federal information return (Form 1099)by the statutory deadline for all payments subject to 1099 reporting made by ICS on behalf of the CLIENT during the term of this Agreement. 5. Additional ad-hoc reports will be provided to CLIENT at their request at no additional cost. Special report requests that require programming time will be charged to CLIENT at $150 per hour,which is the direct cost of ICS. Our system is capable of generating standardized reports as follows: Claim Logs Claim Activity Claim Cost Detail Claim Cost Summary Claim Cost Summary by Year 9IPage DocuSign Envelope ID: 177B557A-79FB-4E9E-B338-6359A5FCBAB8