6414 - Administrative Servies Only (ASO) for Medical and Pharmacy Benefits, 4.Drawings/ Plans/
RFP # 6414
Administrative Services Only (ASO) for Medical & Pharmacy Benefits
Exhibit 4
RFP 6414 Exhibit 4
Administrative Services Only (ASO) For Medical & Pharmacy Benefits
Supplements:
Supplement A – Gold Plan Summary Plan Document
Supplement B – Silver Plan Summary Plan Document
Supplement C – Retiree Choice Summary Plan Document
Supplement D – Claims Experience
Supplement E – Employee & City Contributions & Current Fees
Supplement F– Employee Census
Supplement G – Healthy Incentives Program Summary
Supplement H – Medical Claims Pricing & Network Analysis
Supplement I – Pharmacy Claims Pricing & Network Analysis
SUPPLEMENT A
GOLD PLAN SUMMARY PLAN DOCUMENT
Document available under separate cover