STATE OF MICHIGAN CENTRAL PROCUREMENT SERVICES Department of Technology, Management, and Budget 525 W. ALLEGAN ST., LANSING, MICHIGAN 48913 P.O. BOX 30026 LANSING, MICHIGAN 48909 CONTRACT CHANGE NOTICE Change Notice Number 30 to Contract Number 071B1300215 Reston, VA 20190 Laurie Westfall 517-324-3101 laurielwestfall@maximus.com Contract Administrator STATE CONTRACTOR 11419 Sunset Hills Road Program Manager MAXIMUS HEALTH SERVICES, INCORPORATED Julianne Denny MDHHS 517-335-6710 dennyj@Michigan.gov Douglas Glaser DTMB (517) 294-5632 glaserd@michigan.gov CV0008115 CONTRACT SUMMARY ENROLLMENT BROKER SERVICES - DCH INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE BEFORE April 1, 2011 March 31, 2017 1 - 1 Year March 31, 2023 PAYMENT TERMS DELIVERY TIMEFRAME 0.3NET5, 0.2NET7, 0.1NET10 and NET45 N/A ALTERNATE PAYMENT OPTIONS ☐ Other ☐ PRC ☐ P-Card EXTENDED PURCHASING ☒ No ☐ Yes MINIMUM DELIVERY REQUIREMENTS N/A OPTION LENGTH OF OPTION DESCRIPTION OF CHANGE NOTICE EXTENSION LENGTH OF EXTENSION ☐ ☐ REVISED EXP. DATE March 31, 2023 CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE $454,015,727.00 $105,000,000.00 $559,015,727.00 DESCRIPTION Effective 11/5/2019, per changes to the Healthy Michigan Plan (HMP) law: 1. Beneficiaries to report 80 hours of work or other activities/month. 2. Beneficiaries who have been in an HMP health plan for a cumulative of 48 months have additional requirements which include completing a healthy behavior yearly and if above 100% of the Federal Poverty Level paying a 5% premium. 3. Failure to comply with the new requirements may result in the lose of healthcare coverage. 4. Maximus currently processes HMP MI Health Account (MIHA) co-pays and contributions and will now process and track the new premiums payments and any adjustments. 5. The current MIHA Statements are being modified to include any HMP costs being billed when applicable. 6. Maximus will mail letters related to premiums. 7. Maximus will have a new phone line for reporting the monthly work requirements and exemptions. Staff will be needed to assist beneficiaries reporting work or other activities and for exemption reporting. MAXIMUS is developing an IVR for selfreporting. 8. A Health Risk Assessment Unit will be needed with it's own telephone number to assist beneficiaries who have lost coverage for being non-compliant to become compliant and be allowed back into the HMP program if they meet the rest of the eligibility requirements. 9. Text message reminders and outreach calls will be conducted by the contractor for the new requirement to minimize loss of healthcare coverage. Therefore, the following items are added to this contract, per pricing and scope in the revised attachments: 1. MAXIMUS HMP3 & WR Att A as of 10-2-19, and; 2. 040119 MDHHS HMP3 and Work Requirement Statement of Work - v30 Final Also effective 11/5/2019, this contract is hereby increased by $105,000,000.00 All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Procurement approval. MAXIMUS STATEMENT OF WORK TO AMEND THE MICHIGAN ENROLLMENT BROKER SERVICES CONTRACT NO. 071B1300215 TO IMPLEMENT HEALTHY MICHIGAN PLAN WAIVER 3 AND WORK REQUIREMENTS CONTACT CENTER INTRODUCTION: This Statement of Work (SOW) amends the Michigan Enrollment Broker Services contract (referred to as MI EBS or Contract) in order for MAXIMUS Health Services, Inc. (MAXIMUS) to implement extended services for Healthy Michigan Plan (HMP), under Section 1115 Demonstration Amendment approved by the Centers for Medicare & Medicaid Services (CMS) and P.A. 107 of 2013, to provide Premium and Work Requirements services. This SOW and associated prices set forth in Attachment A, modifies the scope of work and deliverables in section 1.022 of the Contract. Only the subsections of section 1.022 involved in this change notice are included in this SOW. Tasks in sections not included in this SOW will continue to be provided based on the Contract, including approved change orders, as appropriate. The prices presented reflected in this SOW are based on the information available and decisions made as of August 27, 2019. BACKGROUND: The Michigan Department of Health and Human Services (MDHHS) is instituting new premium, healthy behavior, Work Requirements and other qualifying activities, through Public Act (208) of 2018 as part of the amended Healthy Michigan Plan demonstration extension and amendments. Beginning January 1, 2020, beneficiaries who are above 100% of the Federal Poverty Limit (FPL) and have been in an HMP health plan for 48 months, who are not exempt, must pay 5% HMP premiums (Premiums) and complete healthy behavior activities annually. Work Requirements and other qualifying activities for able-bodied HMP beneficiaries, aged 19 to 62, will be effective January 1, 2020. MAXIMUS will provide customer services for self-attestation, exemption requests and general beneficiary support. If premiums are not paid within 30 days or healthy behavior activities are not met by the beneficiary’s redetermination date, the beneficiary’s healthcare coverage may be closed until the beneficiary comes into compliance with premiums and/or healthy behaviors. There are approximately 688,000 beneficiaries that have HMP coverage. Of that total, there were 659,000 that were between the ages of 19 to 62, who would be subject to the Work Requirements criteria. From the group of beneficiaries that are subject to the Work Requirements, 430,000 unique individuals fall into at least one of the criteria that would exempt them from those requirements – noting some duplications. From the group of beneficiaries that are subject to the Work Requirements, approximately 83,000 individuals would fall into at least one of the criteria that meets compliance with Work Requirements and other qualifying activities based on known data in the systems – noting some duplications. By adding those beneficiaries who were exempt and those beneficiaries who are compliant based on known data, and removing duplicates, there Page 1 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final are approximately 481,000 individuals who would not have to report each month, leaving approximately 178,000 beneficiaries who must report their Work Requirements compliance each month. SCOPE OF WORK: The following sections describe changes to the SOW in Section 1.022 of the Contract involved in this SOW. I. HMP Work Requirements Some HMP beneficiaries will be required to report work or other qualifying activities monthly to maintain their health care coverage unless they are determined to be exempt. The monthly nonresponsive rate is expected to be approximately 30% - MAXIMUS is expecting 45,000 net cases closed due to non-compliance (cumulative by end of year 2020). MAXIMUS is expecting 96,000 inbound volume (IVR and CSR monthly average for the first year). MDHHS will implement a “no wrong door” approach, and beneficiaries will have different options for submitting attestations. It is estimated that these will be: 30% for MI Bridges Portal usage (percentage of total required to report, based on MDHHS estimate). 40% for MAXIMUS contact center to provide assisted monthly attestations. 30% for MAXIMUS self-service IVR utilization rate for transactional calls (activity reporting, reporting exemptions, reporting status changes). MAXIMUS will provide a new toll-free number and IVR for self-attestation as well as a new contact center to answer beneficiary inquiries. MDHHS and MAXIMUS agree to possible work stoppage for Work Requirements in accordance with the Contract, Section 2.153 under Termination for Convenience and 2.180, Sections 2.182 through 2.183 under Stop Work. Notwithstanding the foregoing, to the extent that MAXIMUS has incurred costs required in this SOW prior to written notice of work stoppage, such costs shall be reimbursed by MDHHS. These costs shall include any lease costs and finish out related to the new call center facilities to be located in Flint MI set out in Section VI below. 1.1 Call Scope: 1. MAXIMUS will begin handling calls for HMP Work Requirements and exemption reporting and the phone line will be live starting January 27, 2020. Calls may be: a. Inquiries and questions about the HMP program, individual beneficiary status or additional resources. b. Beneficiaries attesting to exemptions. c. Assisting beneficiaries with completing their monthly attestation reporting either through answering questions or submitting the attestation for them. 2. Prior to January 27, 2020, inquiries and questions regarding Work Requirements will be handled through the Beneficiary Helpline. 3. HMP Introductory letters will be mailed to 670,000 beneficiaries starting on September 16, 2019. MAXIMUS may receive an increased volume of inquiry calls prior to the Work Requirement Call Center start date. MI EBS call center will be cross-trained on Work Requirements and will have the ability to answer beneficiary questions pertaining to Work Requirements. Page 2 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 4. MAXIMUS is expecting 200,000 beneficiaries of the 670,000 beneficiary mailings to be considered non-exempt. MAXIMUS expects that 10% of the non-exempt beneficiaries to call resulting in an additional 20,000 calls in September 2019. MAXIMUS expects that 1.5% of the remaining population will call in October 2019 resulting in an additional 7,000 calls. 5. MAXIMUS will document call notes regarding Work Requirements in the State of Michigan (also referred to as the state) Siebel Customer Relationship Management (CRM) system. 6. The MAXIMUS contact center must be available to receive calls from 8:00AM – 7:00 PM EST, Monday through Friday. 7. HMP beneficiaries will use the Work Requirements new toll-free number (833-895-4355) and existing TTYs (866-501-5656 and 888-263-5897), which will be published on Work Requirements letters and other materials. 8. Once calls are completed, phone counselors will transfer the caller to complete an aftercall customer satisfaction survey, unless otherwise specified by the state. 1.2 Outreach Campaigns for Work Requirements: 1. Outbound Text Simple Message Services (SMS): Outbound Text SMS in English will be provided with an opt-in and opt-out option for: a. Outreach as a reminder for monthly reporting obligations; b. Beneficiaries that have opted in for the Outbound Text SMS service will not receive an outbound dialer call. c. Year one is estimated to have more texts than subsequent years since beneficiaries may lose coverage due to non-compliance – text package allows for up to 1.7 million texts per year. 2. Outbound Dialer: An outbound dialer call in English will be provided with an opt-out option for: a. Outreach calls as a reminder for monthly reporting obligations; b. Outreach for countable months, with messaging escalating depending on the number of countable months. c. Only beneficiaries that have not opted in for text messaging will receive an outbound dialer outreach call. d. Year one is estimated to have more calls in the first year – up to 205,000 calls per month (up to 2 attempts per telephone number), since beneficiaries may lose coverage due to non-compliance. 3. MDHHS will provide data files from Bridges for Outbound Dialer and Outbound Text SMS. 1.3 Call Volume: 1. Anticipated beneficiaries that need to report Work Requirements as of February 2020 is approximately 178,000 with an average call volume of 75,000 calls per month. 2. Based on requirements (e.g. approximately 21 questions including branching for reporting and/or exemption qualification and descriptions, texting opt-in and disclaimer language), call lengths are expected to range in the 3.5 to 7.0 minute call tier. Over time, the call length may decrease based on the beneficiary only reporting compliance activity. The complexity of the branching may have an impact on the IVR adoption rate and increase calls in the call center. Page 3 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 3. Those callers that go through self-attestation may request to be routed back to counselors and the calls will increase the call volume into the Work Requirements or MI EBS Call Centers. 1.4 Work Requirements Call Center Staffing: 1. At the onset of the implementation, MAXIMUS will need to recruit, hire, and train new staff. Where staff has already been hired in accordance with an approved project schedule, if the project go-live date is extended past the agreed upon date, due to no fault of MAXIMUS, and trained staff will need to be retained, MDHHS will cover the costs to retain the staff while rescheduling for the new go-live date. 2. Training will be provided based on MAXIMUS training material approved by MDHHS. 1.5 Interactive Voice Response (IVR) System – New IVR Implementation: 1. A new IVR will be developed using a new toll-free number (833-895-4355) as the MAXIMUS IVR for Work Requirements. 2. MAXIMUS will develop and implement an IVR based on MDHHS approved call flows and call handling procedures. 3. Should IVR changes be deemed necessary post implementation, MAXIMUS will modify the IVR as described in Change Notice #11. All IVR messaging will be submitted to MDHHS for review and approval prior to implementation. 4. The Work Requirements IVR is a self-service IVR that provides: a. HMP beneficiaries with 24/7 access, with the exception of scheduled weekly maintenance down times over the weekends, for self-attestation regarding qualifying activities and exemptions. b. Data captured in the IVR will be routed to Bridges. c. The Work Requirements IVR capabilities include but are not limited to Computer Telephony Interface (CTI) – requiring beneficiaries to authenticate. 5. The Work Requirements IVR will also provide routing prompts for beneficiaries requesting a live phone counselor. 1.6 Translation Services: 1. The Work Requirements IVR will need scripting for separate options in English only, with MDHHS approval of call flows with the IVR scripting. 2. MAXIMUS will provide ongoing support of IVR scripting in English. 3. For those calls that are routed to a live phone counselor, MAXIMUS will provide bi-lingual CSRs in Spanish and Arabic or provide Translation Services as needed for other languages or in Spanish and/or Arabic if in the event that a bi-lingual CSR is not available. 1.7 IT Web Service Environments: MAXIMUS resource capacity, and the work and deliverables required for Hosting, Maintenance and Operations (“M&O”), and Enhancements on MAXIMUS Systems are described within the Contract and prior Change Notices and remain in full effect for the term of this SOW. 1. MAXIMUS will add additional MAXeb servers to support implementation of web services interfaces for real-time transfer of HMP Work Requirements (18-MSA-41) attestation data. Servers must be added to all MAXeb environments to provide functionality in Production, to allow development and testing for code changes as directed by the MDHHS, and to train CSRs in the Michigan Enrolls call center. Web services in the UAT Page 4 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final environment must connect to the state’s environments to support integration and end to end testing. 2. MAXIMUS will provide and host a total of 21 additional servers as shown below. These systems must be operational prior to the System Development Life Cycle (SDLC) stage in which they are required according to the dates listed; implementation dates could change based on MDHHS direction and need. Environment Server Function Operational Date Dev 2 Docker Worker Node - Serving Application 7/31/2019 Dev 2 PostgreSQL Database 7/31/2019 QAT 2 Docker Worker Node - Serving Application 7/31/2019 QAT 2 PostgreSQL Database 7/31/2019 UAT 2 Docker Worker Node - Serving Application 7/31/2019 UAT 2 PostgreSQL Database 7/31/2019 Dev 1 Docker Worker Node - Serving Application 10/1/2019 Dev 1 PostgreSQL Database 10/1/2019 QAT 1 Docker Worker Node - Serving Application 10/1/2019 QAT 1 PostgreSQL Database 10/1/2019 UAT 1 Docker Worker Node - Serving Application 10/1/2019 UAT 1 PostgreSQL Database 10/1/2019 Prod Docker Worker Node - Serving Application 10/1/2019 Prod Docker Worker Node - Serving Application 10/1/2019 Prod Docker Worker Node - Serving Application 10/1/2019 Prod Docker Worker Node - Serving Application 10/1/2019 Prod PostgreSQL Database - Primary 10/1/2019 Prod PostgreSQL Database - Backup 10/1/2019 Training Docker Worker Node - Serving Application 10/1/2019 Training MAX EB App Server 10/1/2019 Training PostgreSQL Database 10/1/2019 3. MAXIMUS must conduct penetration testing on web services upon implementation in a Production environment. Penetration testing is required each time a new web service is created or an existing one substantially modified as a result of code changes directed by MDHHS. 1.8 Operations – Fulfillment: 1. MDHHS requested that MAXIMUS mail out a temporary exemption form for those beneficiaries that don’t currently have an exemption and call into the beneficiary Helpline stating that they qualify for an exemption and request an exemption form. a. This is a temporary process from September 2019 through January 2020 or when systems are ready to input the information. b. Exemption form requests will be captured in the CRM system. Page 5 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final c. The exemption form is a pre-printed form that will be inserted into an envelope for mailing by MAXIMUS and the pre-printed exemption form and envelope will be provided to MAXIMUS by MDHHS. d. The average monthly volume is anticipated to be 150. 1.9 Center for Health Literacy (CHL) One-time Request for Work Requirements Materials: Per MDHHS request, CHL will assist with improving consumers’ health literacy by providing recommendations for clear and effective communications that are written in plain language, are culturally and linguistically appropriate, and are designed for visual comprehension. 1. Review and provide revisions on four (4) new Work Requirement letters, an exemption form, a Work and Qualifying Activities Requirements Booklet, and a Premium and Health Behavior Requirements Booklet for September 2019 mail distribution. 2. Review and provide revisions on the December 2019 Letters and additional September 2019 Letters – Nine (9) letters (three (3) September 2019 letters and six (6) versions of exemption letters for December 2019) and one (1) insert “How to Report”. 3. Two (2) Consumer Testing options consisting of 20 hours of one-on-one interviews with 20 participants in English only. 4. Review and provide revisions on three (3) additional September 2019 letters and thirteen (13) Bridges notices. (Note: for September 2019 letters, there are a total of ten (10) letters). 5. Other services upon MDHHS request – see section VI. Center for Health Literacy (CHL) Future Requests 1.10 Reports and Standard Level of Agreements (SLAs): 1. The following are the requirements for reporting SLA’s: a. The wait time in the queue must not be longer than three (3) minutes. b. The abandoned (dropped) call rate must not exceed five (5) percent of the Contractor’s total call volume. c. All telephone calls must be answered within four (4) rings. 2. Other requirement needs for non-SLA reporting: a. Number of transferred calls (call disposition status) and to which lines. b. Number of self-attestations. c. Number of CSR assisted-attestations, IVR assisted-attestations. d. Number of exemptions reported and by type if collected. 3. MAXIMUS will have a standard level of performance grace period as a ramp up period up to three (3) consecutive months and is not dependent on number of facilities. II. Healthy Michigan Plan – New Premiums and Healthy Behavior Requirements HMP beneficiaries who are above 100% of the Federal Poverty Limit (FPL) and have been in an HMP health plan for a cumulative of 48 months will pay a 5% HMP Premium and complete healthy behavior activities, unless exempt. If Premiums or healthy behavior activities are not met, the beneficiary may lose the HMP coverage until the beneficiary has paid the HMP premium owed to the state and/or completed healthy behavior activities. Page 6 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 2.1 Call Scope 1. Calls will be answered by the existing MI EBS Call Center regarding HMP changes, general questions, premium payment questions, exemption requests or other concerns. a. Expecting an increase in volume due to changes to HMP; additional staff may be required. b. The Desk Reference will need to be updated to address changes to HMP in regards to premium requirements, HMP exemptions and healthy behaviors initiatives. c. Phone counselors will use the call flow scripts approved by MDHHS. 2. MAXIMUS phone counselors will document calls in the CRM system. 2.2 Call Handling 1. HMP beneficiaries will use the existing toll free number under MI Enrolls (800-975-7630), Beneficiary Help Line (800-642-3195) and existing TTYs (866-501-5656 and 888-2635897). All processes currently handled in the existing call center will continue to be followed, such as language translations and call center hours. 2. Phone counselors will be trained on the requirements of HMP, and Work Requirements and other qualifying activities. 2.3 Call Volume 1. MAXIMUS expects to receive an increase in call center call volumes about enrollment (and disenrollment) issues – an estimated 10% increase of calls is anticipated. 2. Call volumes are included in MI EBS existing call tiers under Attachment A. 2.4 Interactive Voice Response (IVR) System There will be three separate Category 2 level changes in accordance to Change Notice #11 for IVR changes on the following phone lines - the MIBridges Support Helpdesk (MBSH), Beneficiary Help Line and MI Enrolls IVRs: 1. IVR options on the existing MI EBS call center toll free number will need to be updated for HMP beneficiaries on the Beneficiary Help Line (800-642-3195) IVR and the MI Enrolls (800-975-7630 & 888-367-6557) IVR. The IVRs will include: a. A Work Requirements option to route HMP beneficiaries to the Work Requirements IVR for self-attestation. b. An MBSH option to route HMP beneficiaries for technical assistance accessing MI Bridges for self-attestation. 2. MBSH IVR will include an option to route HMP beneficiaries to the Work Requirements IVR for self-attestation and exemption reporting. 2.5 Mail Fulfillment: Under Section 1557 of the Affordable Care Act (ACA), MDHHS is required to update existing letters with non-discrimination language. Upon MDHHS request, and an anticipated start date of July 1, 2020, MAXIMUS will update 60 existing letters and will also include the 12-point font requirements. III. Premium Operations Beneficiaries that have been in an HMP Health Plan for 48 months and are over 100% FPL must pay a 5% HMP Premium starting February 1, 2020. As of May 2019, the total number of HMP Page 7 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final beneficiaries with continuous failure to pay (CFP - premiums that are 3 months past due or more) is approximately 245,000. The total number of beneficiaries with 5% HMP Premium will be approximately 135,000. Of those, there are approximately 115,000 HMP beneficiaries over 100% FPL that are over the 48 months. 3.1 5% HMP Premiums: 1. The same beneficiary ID will be used for Michigan Health Account (MIHA) and Premiums. 2. MAXIMUS will utilize an Oracle Financial Application (OFA) system for payment collections for Premiums. 3.2 Credit Card and Debit Card Payment Transactions: MDHHS has directed MAXIMUS to expand payment methods for beneficiary payments through credit card and debit card transactions. The process for credit card and debit card is similar to the current Automated Clearing House (ACH) payments: 1. Payment methods will be included on the current MIHA/HMP Account Portal with real time authorization truncating the last 4 digits of the credit card or debit card. 2. The HMP Statement will show the payment method type made by the Beneficiary. 3. Refunds on Credit Card or Debit Card payments will be issued by check. Credit Card or Debit Card rejects will be identified similar to the ACH NSF process. 4. The same PCI DSS requirements for security controls will be in place. MAXIMUS will not store Credit Card/Debit Card Information. 5. MAXIMUS will provide the Health Plans with a payment report by Beneficiaries. Please note that credit card and debit card implementation fee, transaction and processing fees will be charged under a separate agreement with HMP participating Health Plans. 3.3. HMP Statements: 1. There will be one Healthy Michigan Plan Statement. The Healthy Michigan Plan Statement will identify up to four balances – combined, contributions, copay and premium, where applicable as applies to MIHA and/or Premiums. 2. MAXIMUS will send beneficiaries two additional statements after the beneficiary no longer has HMP eligibility if there are past due balances. 3.4 The Online Payment System: 1. The Online Payment vendor will accept online payments for both MIHA and Premium balances. 2. The online payment website will display both the MIHA and Premium balances. 3. The online payment website will be compliant with the Americans with Disabilities Act of 1990 (ADA) in accordance with State policy: ADA Compliance The state is required to comply with the ADA and has adopted a formal policy regarding accessibility requirements for websites and software applications. MAXIMUS, where relevant, must comply to level AA of the World Wide Web Consortium (W3C) Web Content Accessibility Guidelines (WCAG) 2.0. MAXIMUS may consider, where relevant, the W3C’s Guidance on Applying WCAG 2.0 to Non-Web Information and Page 8 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final Communications Technologies (WCAG2ICT) for non-web software and content. http://www.michigan.gov/documents/dmb/1650.00_209567_7.pdf?20151026134621 3.5 MIHA and HMP Lockbox: 1. Beneficiary payments are applied to all Premium balances first before applying to MIHA balance, except when an offset is received. 3.6 HMP Refunds: 1. Refunds will be issued to HMP beneficiaries if an overpayment that has aged 60 days cannot be applied to the next monthly billing or outstanding MIHA balance. 2. Premium overpayments can be applied to MIHA, if applicable. 3.7 Offsets and Voucher Disbursements: 1. Lottery payments and Tax offsets a. Lottery payments and Tax offsets have to go directly to MIHA accounts first. b. Any overage of the lottery payments or tax offset can be applied to Premium account after applying to any MIHA balances due unless the beneficiary requests a refund. c. Applied lottery and tax offset payments to Premium accounts will result in a letter where the beneficiary can ask for a refund of the portion applied to Premiums. 2. MIHA Voucher Disbursements a. MIHA Voucher disbursements will be applied to Premium balances before being considered for return to the beneficiary. b. There are no voucher disbursements for Premiums. 3.8 Premium Collections: 1. If the beneficiary does not pay their account balance within approximately 25 days of the due date the beneficiary will be sent as premium non-compliant to Bridges and could have his/her HMP coverage closed. 2. The closure of healthcare coverage will result in an MDHHS letter. 3.9 Mail Fulfillment: While MDHHS will draft all communications, MAXIMUS will print and mail specific letters on behalf of MDHHS and Health Plans. MDHHS has requested that all HMP letters be reprintable. MAXIMUS will provide correspondence reprints to beneficiaries as required by MDHHS. Please note that mail fulfillment fees will be charged under a separate agreement with HMP participating Health Plans. All new and existing letters for the Health Plans will be Section 1557 compliant with 12-point font and be available as scheduled on or after the January 27, 2020 golive as set out in this SOW. 1. Letters for HMP: a. Quarterly Statement for MIHA and Premiums b. Adjustment Letter for MIHA and Premiums c. Late Pay Letter for Premiums d. Refund Letter for MIHA and Premiums / 3rd Party Refund for MIHA and Premiums e. NSF Letter for MIHA and Premiums Page 9 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final f. Premium Receipt Letter for MIHA or Premiums g. HMP Offset Applied Letter (tax or lottery payment applied) h. MIHA Welcome back letter 2. Replacement Letters (Reprints) for all MIHA and Premium letters: a. Quarterly Statement for MIHA and Premiums b. Adjustment Letter for MIHA and Premiums c. Late Pay Letter for Premiums d. Refund Letter for MIHA and Premiums / 3rd Party Payer Refund Letter for MIHA or Premiums e. NSF Letter for MIHA and Premiums f. Premium Receipt Letter for MIHA or Premiums g. MIHA Welcome Back Letter for MIHA h. HMP Offset Applied Letter (tax or lottery payment applied) i. MIHA Change Letters j. MIHA Voucher Letters k. MIHA Pre-offset Letters 3.10 Center for Health Literacy (CHL) One-time Request for Premium Materials: Per MDHHS request, CHL will assist with improving consumers’ health literacy by providing recommendations for clear and effective communications that are written in plain language, are culturally and linguistically appropriate, and are designed for visual comprehension. 1. Review and provide revision on new letters and Premium Statement drafts. 2. Review and provide revisions on existing MIHA letters, brochures, and inserts. 3. Other services upon MDHHS request – see section VI. Center for Health Literacy (CHL) Future Requests 3.11 MAX OFA Portal: 1. The MAX OFA Portal will be updated to allow reprints of all letters created by MAX OFA for Premiums and MIHA. 2. The MAX OFA Portal is also being updated to show Premium balances. 3. MAX OFA will have the ability to change the number of months of reprints allowed to be requested by a beneficiary at MDHHS discretion. 4. MAXIMUS will provide the PDF storage space necessary at a fixed cost per terabyte. MDHHS has the option to reduce the year(s) of storage at their discretion based on usage and need. Current usage is projected to go up to 7 terabytes in Fiscal Year 2020. 5. MDHHS designated staff, consisting of 100 or more, will be provided access to the MAX OFA Portal with online webinar training. 3.12 Premium HMP/OFA Research Support for MIHA Department Reviews and HMP Administrative Hearings: 1. Information for hearings is required for Department Reviews and Administrative Hearings – anticipating up to 133 beneficiary dispute cases per month in the base tier. 2. MAXIMUS will provide correspondence to MDHHS for Department Reviews and Administrative Hearings. Page 10 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 3. MAXIMUS will be required to have a 48-hour (2 business day) turnaround time performance standard for hearing administrative requests to support MIHA Department Reviews and HMP Administrative Hearings. 4. Premium Operations staff will be increased to accommodate the anticipated volumes for administrative assistance for MIHA Department Reviews and HMP Administrative Hearings. 3.13 Staffing 1. Effective of January 2020, the Premium Operations staff will provide MIHA Department Reviews and HMP Administrative Hearing processing tasks that include daily/monthly transaction balancing, customer service tasks (SR’s, Incoming/Outgoing Phone Inquiries, and Correspondence). Dispute case processing includes MIHA flag updates, account review & research with 2 case review meetings per week, and adjustments as directed by MDHHS. 2. Due to the increase of collections and complexities of the new requirements, there will be an increase in premium operations staff. 3. Training of staff will be needed with the new requirements under the changes from the HMP Waiver. 3.14 SSAE 18 Audit: 1. An extension of the Statement on Standards for Attestation Engagements (SSAE) 18 audit, conducted under the authority of the right to audit, will increase the scope of the audit due to these changes in the HMP Waiver and associated operations. IV. Health Risk Assessment Unit MAXIMUS will re-establish a Health Risk Assessment Unit (HRA Unit) staffed by qualified licensed registered nurses and/or certified health educators, or others as directed by MDHHS that will enable beneficiaries to complete a Health Risk Assessment and attest to a healthy behavior. 4.1 HRA Unit Operations: 1. HRA Unit will use the existing toll-free number, 833-420-8278, and existing TTYs (866501-5656 and 888-263-5897), which will be published in MDHHS correspondence and/or potentially on other marketing materials. 2. The MAXIMUS HRA Unit must be available to receive calls from 8:00AM – 5:00 PM EST, Monday through Friday. 4.2 Call Scope: 1. The HRA Unit will receive calls from individuals who lost their healthcare coverage due to non-compliance with healthy behaviors, so that these individuals may complete an HRA and re-apply to MDHHS for healthcare coverage. 2. The HRA Unit will complete the entire HRA through attestation via direct entry into CHAMPS starting March 1, 2020. 3. HRA Unit will also transfer calls to MI EBS, if applicable. 4. MDHHS to provide a flat data file to support the outbound dialer; the outbound dialer will be used with opt-out (do not call) option required. Page 11 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 4.3 Call Volume: 1. MDHHS estimated that 19,635 HMP beneficiaries that have not completed healthy behavior activities within the 12 months, as of September 1, 2020, may lose their HMP coverage. 2. From March 2020 to September 2020, it is anticipated that there will be an average of 2,800 calls per month to conduct an HRA from loss of coverage due to healthy behavior non-compliance. 3. Beneficiaries’ loss of coverage is determined at redetermination period. 4. MAXIMUS will be an augmented function for those individuals that lose health care coverage due to non-compliance and will need to complete an HRA before re-applying for health care coverage. 5. The primary physician or health plan will have the primary function in completing HRAs annually for HMP beneficiaries. 4.4 Staffing of HRA Unit: 1. Since the scope is now reduced to those individuals that have lost coverage due to noncompliance with their HRA, there will be no ramp up period for the HRA Unit due to estimated lower on-going volumes of calls after the first month. 2. HRA Advisors will be licensed registered nurses and/or degreed (BA or MA Degree) health educators with knowledge of Prochaska and DiClemente’s Stages of Change Model, unless otherwise directed by MDHHS. 3. Training will be provided based on MAXIMUS training material approved by MDHHS. 4.5 IVR Implementation: 1. For the HRA Unit, MAXIMUS will use the existing toll-free number, 833-420-8278, and use the existing HRA IVR and TTY 866-501-5656. 2. Outbound dialer will be included in scope with an opt-out (do not call) option required. MDHHS will provide MAXIMUS a monthly HSDW flat data file (Optum) for those individuals that lost health care coverage due to healthy behavior non-compliance. 3. There will be two separate Category 2 level changes, in accordance Change Notice #11, for the HRA Unit to the MI EBS Call Center, and from the HRA Unit to the Work Requirements IVR for self-attestation. 4.6 Translation Services: 1. MAXIMUS will provide bi-lingual phone counselors in Spanish and Arabic, and/or provide Translation Services as needed for other languages or in Spanish and/or Arabic in the event that a bi-lingual phone counselors are not available to assist the HRA Unit with these calls. 4.7 Operations - Fulfillment: 1. MDHHS will draft, create and mail the correspondence, which contains the HRA Unit phone number. 4.8 HRA Reports and Standard Level of Agreements (SLAs): 1. Performance Category: HRA Unit Performance commitment(s): a. The wait time in the queue must not be longer than ten (10) minutes. b. The abandoned (dropped) call rate must not exceed ten (10) percent of the Contractor’s total call volume. Page 12 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 2. 3. 4. 5. c. All telephone calls must be answered within four (4) rings (a call pick-up system which places the calls in a queue may be used). MAXIMUS will have a standard level of performance grace period as a ramp up period up to three (3) consecutive months and is not dependent on number of facilities. Measurement: Monthly Reports a. At Risk Fees: $2,500.00 for each month the Contractor fails to meet a Performance Commitment. Other requirement needs for non-SLA reporting: a. Number of outbound and inbound calls b. Number of HRAs Completed c. Number of HRAs Incomplete d. Transferred calls to MI EBS e. Transferred calls to report Work Requirements f. MAXIMUS can provide reports on these areas only by systematically accessing through CHAMPS screens (i.e. MAXIMUS must have access to these CHAMPS screens to report results to MDHHS). Performance Category: Customer Service a. Performance Commitments(s): The Contractor will notify MDHHS of any changes to its HRA Unit desk reference. b. The Contractor will make available to MDHHS a copy of its desk reference on a monthly basis and each time changes are made. c. Measurement: Monthly notification d. At Risk Fees: $2,500.00 for each month the Contractor fails to meet the Performance Commitment. 4.9 Training Materials: 1. Training materials for MAXIMUS will be developed and maintained through an electronic desk reference. 4.10 Desk Reference: 1. MAXIMUS will update and maintain an electronic desk reference, with revisions made within 7 business days of MDHHS approval, or in the case of an emergent request as expeditiously as possible. MDHHS will provide specific information, input and approval of content to ensure the information provided to customers is consistent. 2. The desk reference will provide all necessary information, call scripts, policies and work instructions for phone counselors. 3. MDHHS will be provided an electronic Desk Reference with updates on a monthly basis. 4.11 Call Center Reports: 1. MAXIMUS will modify existing reports or create new reports, in accordance with MDHHS approval, to reflect any changes in telephone calls handled by MAXIMUS as a result of this change notice. MAXIMUS will work with MDHHS to develop new reports, if necessary. V. Integrated Quality Assurance (QA) Program: 5.1 MAXIMUS will develop and maintain a QA program for Work Requirements, HRA Unit and Premium Operations. Page 13 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final VI. Center for Health Literacy (CHL) Future Requests: Upon MDHHS request for future work, MAXIMUS will provide standardize pricing for review and design services to assist with consumers’ health literacy communications by providing recommendations for clear and effective communications that are written in plain language, are culturally and linguistically appropriate, and are designed for visual comprehension. 6.1 Readability for paper materials and digital (including website, mobile app, SMS or email notifications). 6.2 Design for paper materials and digital (including website, mobile app, SMS or email notifications). 6.3 Accessibility for audit and summary reports as well as consulting and remediation guidance. 6.4 Testing and all other services (e.g. readability and design of materials for people with disabilities). VII. Outbound Text SMS Category Change Control: 1. MAXIMUS will provide MDHHS with Outbound Text SMS category pricing for future change control or new Outbound Text SMS requests with optional custom reporting: a. Category 1: Updates to existing campaign content. b. Category 2: New Outbound Text SMS campaign with single message. c. Category 3: New Outbound Text SMS campaign with multi-message workflow (polls, surveys). d. Category 4: Revisions on Custom Reporting Automation VIII. The Annual Hosting, Maintenance and Operations (M & O) and Enhancements on MAXIMUS Systems: The Contractor must continue to provide Hosting, Maintenance and Operations (“M&O”), and Enhancements on MAXIMUS Systems: 7.1 ACA Systems, referred to as systems supporting Eligibility: MAGI Inquiry Viewer Tool Data Collection Tool (DCT) Presumptive Eligibility (PE) (healthcare4mi.com/pe). 7.2 OFA Systems referred to as systems supporting Enrollment: MI Health Account Oracle Financials Application (MIHA OFA) Freedom to Work Oracle Financials Application (FTW OFA) MIChild Oracle Financials Application (MIChild OFA) MI Health Account Portal (mihealthaccountportal.com). 7.3 MAXeb Systems referred to as systems supporting Enrollment: MAXeb MI Enrolls Portal (healthcare4mi.com). 7.4 Contractor resource Capacity, and the Work and Deliverables required for Hosting, Maintenance and Operations (“M&O”), and Enhancements on MAXIMUS Systems are described within the Contract and prior CCNs and remain in full effect for the term of this SOW. Note: Pricing for IT is under section 10.6.1, 10.6.2 and 10.6.3. VIII. Facility Locations: Page 14 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final The increase in volume will impact the facility space located in East Lansing, Michigan. The main location for call center operations is in the East Lansing, Michigan, for services included in Sections 1.022.A, 1.022.B, and 1.022.G.b.1 as approved under Change Notice #11. Work Requirements and overflow from other call centers will be located in another facility located in Michigan. 8.1 MAXIMUS will be expanding the current MI EBS call center in East Lansing, MI to a new facility in the Flint, MI area to initially support the Healthy Michigan Plan demonstration extension with Work Requirements and to allow for future expansion to improve first call resolution with coordinated assistance for Tier 1 calls. Improving service delivery on multiple fronts including the expansion of customer service in three of MAXIMUS existing call centers (MI EBS, Customer Support Call Center {CSCC} & MI Bridges Support Help Desk {MBSH}) to support MDHHS future plan to continue their Universal Caseload (UCL) Program launch (rollout currently on hold as of November 2018 after 20% of counties rolled out, i.e. 80% of larger counties are pending). While the rollout is on hold, MAXIMUS is working with MDHHS to accurately forecast support needed when the rollout continues and provide space for ease of timely resumption. IX. Other Systems Information also in Change Notice #23: 9.1 IT Policies, Standards and Procedures (PSP) MAXIMUS is advised that the state has methods, policies, standards and procedures that have been developed over the years. All services and products provided as a result of this SOW must comply with all applicable state IT policies and standards. MAXIMUS is required to review all applicable links provided below and state compliance in their response. IT Policies, Standards and Procedures (PSP): http://www.michigan.gov/dtmb/0,4568,7-15056355_56579_56755---,00.html 9.2 Acceptable Use Policy To the extent that MAXIMUS has access to the state’s computer system, MAXIMUS must comply with the state’s Acceptable Use Policy, see http://michigan.gov/dtmb/0,4568,7-15056355_56579_56755---,00.html. All MAXIMUS personnel will be required, in writing, to agree to the state’s Acceptable Use Policy before accessing the state’s system. The state reserves the right to terminate MAXIMUS’ access to the state’s system if a violation occurs. 9.3 Look and Feel Standard All software items provided by MAXIMUS must adhere to the following Look and Feel Standards: http://www.michigan.gov/documents/som/Look_and_Feel_Standards. X. PRICING: 10.1 Work Requirements: 10.1.1 One-time Work Requirements Implementation Price: Total $3,603,275. Cost includes all work to implement new call center in half of new facility (~18,200 sq ft). Implementation support includes: TTY, Toll Free Phone Lines, Outbound Dialer, Text SMS, IVR, reports, onboarding of staff both prior to go-live for planning and training, documentation, new facility buildout, network and physical security, PC, software and furniture. Additional ~18,200 sq ft of space will be finished Page 15 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final to include wiring, paint, and carpet. PCs, software, and furniture will be priced at a later date as new work is identified and comes online. The overall new space (36,400 SF) is anticipated to accommodate up to 450 staff (e.g. CSRs, Leads, Supervisors, Management and support staff – final seating will be determined once the lease is executed and architectural drawings are completed). 10.1.2 One-time Center of Health Literacy (CHL) Review Services: Total $159,000. Cost includes review and recommendations on content and design for the following: 1. September 2019 Letters, Exemption form and booklets: $35,000. 2. December 2019 Letters, additional September 2019 Letters and form: $60,000. 3. Optional Consumer Testing: $45,000. 4. Additional three (3) September 2019 Letters and thirteen (13) Bridges Notices: $19,000. 10.1.3 One-Time MAXeb Server Management Implementation Fee: Total $56,682.00. Payment for standing up the additional MAXeb web services servers will be made on a one-time, firm fixed cost basis once all servers are confirmed as Operational, which is expected on or before December 31, 2019: One Time Activity Security Scan(s)* Setup Labor Total Cost $44,280.00 $12,402.00 $56,682.00 *The one-time cost for ”security scans” is a third-party service provided by Synopsys, Inc. to conduct penetration testing on the web service. The scan identifies any vulnerabilities that may be present in the code and provides remediation guidance. The cost covers web service scans on the 4 Production servers added in this SOW. The Contractor must provide screen shots of servers clearly indicating date, OS, RAM, and storage. 10.1.4 On-going Work Requirement Fees: 1. MAXIMUS System Server Management (Hosting): see section 10.6 for IT Pricing. 2. Outbound Text SMS campaign for outreach - a fixed price annual structure and is included in Attachment A. MAXIMUS will incur the cost for the text package up front but will bill on a monthly basis (i.e. monthly fee of $5,928 is in Attachment A). It should be noted if the Work Requirements program is stopped under termination for convenience, these costs will need to be paid for a 12-month period from when the package started (i.e. August 2019). 3. Outbound Dialer campaign for outreach – per call pricing for outbound calls is included in Attachment A (a call back option is available upon request). 4. Work Requirements Inbound Call Volume – monthly pricing for inbound calls to the call center is included in Attachment A tiers. 10.2 HMP and Premium Operations: 10.2.1 One-Time HMP and Premium Operation Implementation Fee: Total $13,921. Cost includes implementation support and all other development work required to implement this call center (including Portal Changes and Premium Operations training). Page 16 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 10.2.2 One-Time Implementation for Section 1557 Compliance, non-discrimination language and 12-point font requirements is covered to program and make template modifications for impacted letters. Upon request by MDHHS, Tag Line insertion pricing is optional in Attachment A. 10.2.3 One-time Center of Health Literacy Review Services: $43,664. Cost includes review and recommendations on content for new Premium letters, existing MIHA letters and new statements. Should these letters have to be revised based on recent changes being made to other MDHHS letters and wording, additional fee(s) may be applicable based on the CHL Ala Cart Services pricing in Attachment A. 10.2.4 One-Time Implementation for Category 2 IVR Option Changes, in accordance to Change Notice #11, to include Work Requirements option: Total $19,005. 1. MI Enrolls IVR change - $6335. 2. Beneficiary Helpline IVR change to include Work Requirements option - $6335. 3. MI Bridges Support Helpdesk IVR change - $6335. 10.2.5 Ongoing HMP and Premium Operation Fees: 1. Premiums SSAE 18 Audit - $31,000, annually starting in fiscal year 2020. 2. MAXIMUS will provide the PDF storage space necessary at a fixed cost per terabyte. MDHHS has the option to reduce the year(s) of storage at their discretion based on usage and need. Current usage is projected to go up to 7 terabytes in Fiscal Year 2020 as reflected in Attachment A. a. Monthly billing will be based on actual terabytes used. b. MAXIMUS will bill to the nearest whole terabyte used (i.e. if less than or equal to 4.5 terabytes, MDHHS will be billed at 4 terabytes and if greater or equal to 4.51 terabytes, MDHHS will be billed at 5 terabytes). For monthly invoice supporting documentation, a screen shot will be provided to show the terabytes used. 3. Temporary Exemption Form and Letter: the tiered pricing is included in Attachment A. 4. Premium Staff – Processing tasks included are daily/monthly transaction balancing, customer service tasks (SR’s, Incoming/Outgoing Phone Inquiries, Correspondence), and up to 133 beneficiary dispute cases per month in the base tier. Dispute case processing includes MIHA flag updates, account review & research, 2 case review meetings per week, and adjustments as directed by MDHHS. Additional tiers include an increase of case load greater than 133 per month and are included in Attachment A. 5. Updating MDHHS existing letters for Section 1557 Compliance, non-discrimination language and 12-point font requirements – the tiered pricing is included in Attachment A. 10.3 HRA Unit: 10.3.1 One-time HRA Implementation Price: Total $62,318. Cost includes implementation support, IVR deployment, and all other development work required to implement this call center (including Outbound Dialer Implementation, reporting, recruiting, training, and documentation). Page 17 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 10.3.2 One-Time Implementation for Category 2 IVR Option Changes, in accordance to Change Notice #11, to include Work Requirements option: 1. HRA IVR change - $6335. 10.3.3 Ongoing HRA fees: 1. HRA Outbound Dialer campaign – monthly pricing for inbound (call back option) and outbound calls is in Attachment A. 2. HRA Staffing - fixed pricing with tiered staffing based on-going stable volume of calls included in Attachment A. 10.4 Center for Health Literacy (CHL) Future Requests: pricing table for future requests will be included in Attachment A. 10.5 Outbound Text SMS Category Change Control: pricing table for future requests will be included in Attachment A as outlined below: a. Category 1: $2,344. Updates to existing campaign content. b. Category 2: $4,647. New Outbound Text SMS campaign with single message. c. Category 3: $9,294. New Outbound Text SMS campaign with multi-message workflow (polls, surveys). d. Category 4: $13,850. Custom Reporting Automation Revision(s) 10.6 IT Pricing 10.6.1 Change Notice #26 Payment Schedule Table 3 - MAXIMUS System Server Management (Hosting) is modified and updated as shown below: State Month of Service FY19 Payment Payment # ACA Server Management OFA Server Management MAXeb Server Management 1 October 2018 $27,399.00 $48,879.00 $29,226.00 2 November 2018 $27,399.00 $48,879.00 $29,226.00 3 December 2018 $27,399.00 $48,879.00 $29,226.00 4 January 2019 $27,399.00 $48,879.00 $29,226.00 5 February 2019 $27,399.00 $48,879.00 $41,151.00 6 March 2019 $27,399.00 $48,879.00 $41,151.00 7 April 2019 $27,399.00 $48,879.00 $41,151.00 8 May 2019 $27,399.00 $48,879.00 $41,151.00 Page 18 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final 9 June 2019 $27,399.00 $48,879.00 $41,151.00 10 July 2019 $27,399.00 $48,879.00 $41,151.00 11 August 2019 $27,399.00 $48,879.00 $44,445.00 12 September 2019 $27,399.00 $48,879.00 $44,445.00 $328,788.00 $586,548.00 $452,700.00 TOTALS: State FY19 Hosting cost ACA, OFA, and MAXeb Totals $1,368,036.00 Note: MAXeb servers will increase starting in August 2019. ACA and OFA servers are a carry-over from Change Notice #26. This FY20 pricing for MAXIMUS System Server Management (Hosting) will continue through March 31, 2023. State FY20 Month of Service Payment # Payment ACA Server Management OFA Server Management MAXeb Server Management 1 October 2019 $27,399.00 $48,879.00 $54,121.00 2 November 2019 $27,399.00 $48,879.00 $54,121.00 3 December 2019 $27,399.00 $48,879.00 $54,121.00 4 January 2020 $27,399.00 $48,879.00 $54,121.00 5 February 2020 $27,399.00 $48,879.00 $54,121.00 6 March 2020 $27,399.00 $48,879.00 $54,121.00 7 April 2020 $27,399.00 $48,879.00 $54,121.00 8 May 2020 $27,399.00 $48,879.00 $54,121.00 9 June 2020 $27,399.00 $48,879.00 $54,121.00 10 July 2020 $27,399.00 $48,879.00 $54,121.00 11 August 2020 $27,399.00 $48,879.00 $54,121.00 12 September 2020 $27,399.00 $48,879.00 $54,121.00 Page 19 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final TOTALS: $328,788.00 $586,548.00 State FY20 Hosting cost ACA, OFA, and MAXeb Totals 1. $649,456.00 $1,564,792.00 Web Services Penetration Testing – Penetration testing is required each time a new web service is created or an existing one substantially modified as a result of code changes directed by MDHHS. In such instances, payment will be made on a one-time, firm fixed cost basis in amount of $11,070 per server that is scanned; pricing is in Attachment A. Annual Hosting, Maintenance and Operations (M & O) and Enhancements on MAXIMUS Systems Pricing: 10.6.2 MAXIMUS System Enhancements: CCN26 Payment Schedule System Enhancements is revised and updated as shown below to extend pricing through Fiscal Year 2020. This FY20 pricing for MAXIMUS System Enhancements will continue through March 31, 2023. State FY20 Payment # 1 2 3 4 5 6 7 8 9 10 11 12 Month of Service Payment October 2019 November 2019 December 2019 January 2020 February 2020 March 2020 April 2020 May 2020 June 2020 July 2020 August 2020 September 2020 TOTALS: State FY20 Enhancement cost ACA, OFA, and MAXeb Totals ACA Enhancements $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $1,372,800 OFA Enhancements $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $358,800 $4,305,600 MAXeb Enhancements $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $114,400 $1,372,800 $7,051,200 10.6.3 MAXIMUS Operational Support Resources: CCN26 Payment Schedule Operational Support Resources is revised and updated as shown below to extend pricing through Fiscal Year 2020. This FY20 pricing for MAXIMUS Operational Support Resources will continue through March 31, 2023. Page 20 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final State FY20 Payment # 1 2 3 4 5 6 7 8 9 10 11 12 Month of Service Payment October 2019 November 2019 December 2019 January 2020 February 2020 March 2020 April 2020 May 2020 June 2020 July 2020 August 2020 September 2020 TOTALS: State FY20 Operations cost ACA, OFA, and MAXeb Totals ACA Operations $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $41,600 $499,200 OFA Operations $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $242,320 $2,907,840 MAXeb Operations $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $143,645 $1,723,740 $5,130,780 Note: IT pricing for Hosting, Maintenance and Operations (M & O) and Enhancements on MAXIMUS Systems, Maximus System Enhancement and Operation Support Resources are shown above through Fiscal Year 2020. This FY20 IT pricing referenced in the prior sentence will continue through March 31, 2023. Staffing was reduced under Change Notice #28 and there will be a ramp up period while MAXIMUS refills positions for ACA and MAXeb (Enhancement and/or Operations Support areas as applicable). Monthly billing will be prorated until positions are filled. Note: Reference Attachment B for all one-time implementation fees and totals in this SOW. Page 21 of 21 MAXIMUS / MDHHS HMP and Work Requirement SOW August 27, 2019 V28 Final MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Beneficiary Helpline (includes MI Health Care Helpline calls) Reference 1.022.A Method a) Fixed price for monthly call volume up to 56,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 5.5 MINUTES PER CALL Year Price (12 months) a) $3,684,241 Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $3,684,241 a) $3,684,241 a) $3,684,241 a) $3,684,241 b) Fixed price for monthly call volume at least 10% greater than 56,000, including all related sub-tasks b) $3,826,842 b) $3,826,842 b) $3,826,842 b) $3,826,842 b) $3,826,842 c) Fixed price for monthly call volume at least 20% greater than 56,000, including all related sub-tasks c) $4,068,225 c) $4,068,225 c) $4,068,225 c) $4,068,225 c) $4,068,225 d) Fixed price for monthly call volume at least 30% greater than 56,000, including all related sub-tasks d) $4,347,137 d) $4,347,137 d) $4,347,137 d) $4,347,137 d) $4,347,137 e) Fixed price for monthly call volume at least 40% greater than 56,000, including all related sub-tasks e) $4,701,684 e) $4,701,684 e) $4,701,684 e) $4,701,684 e) $4,701,684 f) Fixed price for monthly call volume at least 50% greater than 56,000, including all related sub-tasks f) $5,041,595 f) $5,041,595 f) $5,041,595 f) $5,041,595 f) $5,041,595 g) Fixed price for monthly call volume at least 75% greater than 56,000, including all related sub-tasks g) $5,894,111 g) $5,894,111 g) $5,894,111 g) $5,894,111 g) $5,894,111 h) Fixed price for monthly call volume at least 100% greater than 56,000, including all related sub-tasks h) $6,724,846 h) $6,724,846 h) $6,724,846 h) $6,724,846 h) $6,724,846 i) Fixed price for monthly call volume at least 130% greater than 56,000, including all related sub-tasks i) $7,740,958 i) $7,740,958 i) $7,740,958 i) $7,740,958 i) $7,740,958 j) Fixed price for monthly call volume at least 150% greater than 56,000, including all related sub-tasks j) $8,458,862 j) $8,458,862 j) $8,458,862 j) $8,458,862 j) $8,458,862 k) Fixed price for monthly call volume at least 175% greater than 56,000, including all related sub-tasks k) $9,212,373 k) $9,212,373 k) $9,212,373 k) $9,212,373 k) $9,212,373 l) Fixed price for monthly call volume at least 200% greater than 56,000, including all related sub-tasks l) $9,950,567 l) $9,950,567 l) $9,950,567 l) $9,950,567 l) $9,950,567 m) Fixed price for monthly call volume at least 225% greater than 56,000, including all related sub-tasks m) $10,673,676 m) $10,673,676 m) $10,673,676 m) $10,673,676 m) $10,673,676 n) Fixed price for monthly call volume at least 250% greater than 56,000, including all related sub-tasks n) $11,381,933 n) $11,381,933 n) $11,381,933 n) $11,381,933 n) $11,381,933 o) Fixed price for monthly call volume at least 275% greater than 56,000, including all related sub-tasks o) $12,085,965 o) $12,085,965 o) $12,085,965 o) $12,085,965 o) $12,085,965 p) Fixed price for monthly call volume at least 300% greater than 56,000, including all related sub-tasks p) $12,765,340 p) $12,765,340 p) $12,765,340 p) $12,765,340 p) $12,765,340 q) Fixed price for monthly call volume at least 325% greater than 56,000, including all related sub-tasks q) $13,429,133 q) $13,429,133 q) $13,429,133 q) $13,429,133 q) $13,429,133 n) Fixed price for monthly call volume at least 350% greater than 56,000, including all related sub-tasks r) $14,133,440 r) $14,133,440 r) $14,133,440 r) $14,133,440 r) $14,133,440 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 1 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Beneficiary Helpline (includes MI Health Care Helpline calls) Beneficiary Helpline (includes MI Health Care Helpline calls) Reference 1.022.A Method n) Fixed price for monthly call volume at least 375% greater than 56,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price s) $14,828,397 s) $14,828,397 s) $14,828,397 s) $14,828,397 s) $14,828,397 n) Fixed price for monthly call volume at least 400% greater than 56,000, including all related sub-tasks t) $15,545,169 t) $15,545,169 t) $15,545,169 t) $15,545,169 t) $15,545,169 n) Fixed price for monthly call volume at least 425% greater than 56,000, including all related sub-tasks u) $16,255,708 u) $16,255,708 u) $16,255,708 u) $16,255,708 u) $16,255,708 n) Fixed price for monthly call volume at least 450% greater than 56,000, including all related sub-tasks v) $16,960,015 v) $16,960,015 v) $16,960,015 v) $16,960,015 v) $16,960,015 a) Fixed price for monthly call volume up to 56,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 5.6 AND 8.5 MINUTES PER CALL a) $5,398,265 a) $5,398,265 a) $5,398,265 a) $5,398,265 a) $5,398,265 b) Fixed price for monthly call volume at least 10% greater than 56,000, including all related sub-tasks b) $5,715,043 b) $5,715,043 b) $5,715,043 b) $5,715,043 b) $5,715,043 c) Fixed price for monthly call volume at least 20% greater than 56,000, including all related sub-tasks c) $6,131,356 c) $6,131,356 c) $6,131,356 c) $6,131,356 c) $6,131,356 d) Fixed price for monthly call volume at least 30% greater than 56,000, including all related sub-tasks d) $6,526,494 d) $6,526,494 d) $6,526,494 d) $6,526,494 d) $6,526,494 e) Fixed price for monthly call volume at least 40% greater than 56,000, including all related sub-tasks e) $7,110,813 e) $7,110,813 e) $7,110,813 e) $7,110,813 e) $7,110,813 f) Fixed price for monthly call volume at least 50% greater than 56,000, including all related sub-tasks f) $7,622,509 f) $7,622,509 f) $7,622,509 f) $7,622,509 f) $7,622,509 g) Fixed price for monthly call volume at least 75% greater than 56,000, including all related sub-tasks g) $8,875,307 g) $8,875,307 g) $8,875,307 g) $8,875,307 g) $8,875,307 h) $10,106,734 h) $10,106,734 h) $10,106,734 h) $10,106,734 h) $10,106,734 i) Fixed price for monthly call volume at least 130% greater than 56,000, including all related sub-tasks i) $11,696,532 i) $11,696,532 i) $11,696,532 i) $11,696,532 i) $11,696,532 j) Fixed price for monthly call volume at least 150% greater than 56,000, including all related sub-tasks j) $12,757,289 j) $12,757,289 j) $12,757,289 j) $12,757,289 j) $12,757,289 k) Fixed price for monthly call volume at least 175% greater than 56,000, including all related sub-tasks k) $13,894,238 k) $13,894,238 k) $13,894,238 k) $13,894,238 k) $13,894,238 l) Fixed price for monthly call volume at least 200% greater than 56,000, including all related sub-tasks l) $15,007,941 l) $15,007,941 l) $15,007,941 l) $15,007,941 l) $15,007,941 m) Fixed price for monthly call volume at least 225% greater than 56,000, including all related sub-tasks m) $16,098,749 m) $16,098,749 m) $16,098,749 m) $16,098,749 m) $16,098,749 n) Fixed price for monthly call volume at least 250% greater than 56,000, including all related sub-tasks n) $17,167,015 n) $17,167,015 n) $17,167,015 n) $17,167,015 n) $17,167,015 h) Fixed price for monthly call volume at least 100% greater than 56,000, including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 2 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Beneficiary Helpline (includes MI Health Care Helpline calls) Beneficiary Helpline (includes MI Health Care Helpline calls) Reference 1.022.A Method o) Fixed price for monthly call volume at least 275% greater than 56,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price o) $18,279,810 o) $18,279,810 o) $18,279,810 o) $18,279,810 o) $18,279,810 p) Fixed price for monthly call volume at least 300% greater than 56,000, including all related sub-tasks p) $19,322,246 p) $19,322,246 p) $19,322,246 p) $19,322,246 p) $19,322,246 q) Fixed price for monthly call volume at least 325% greater than 56,000, including all related sub-tasks q) $20,342,867 q) $20,342,867 q) $20,342,867 q) $20,342,867 q) $20,342,867 n) Fixed price for monthly call volume at least 350% greater than 56,000, including all related sub-tasks r) $21,341,673 r) $21,341,673 r) $21,341,673 r) $21,341,673 r) $21,341,673 n) Fixed price for monthly call volume at least 375% greater than 56,000, including all related sub-tasks s) $22,377,876 s) $22,377,876 s) $22,377,876 s) $22,377,876 s) $22,377,876 n) Fixed price for monthly call volume at least 400% greater than 56,000, including all related sub-tasks t) $23,398,497 t) $23,398,497 t) $23,398,497 t) $23,398,497 t) $23,398,497 n) Fixed price for monthly call volume at least 425% greater than 56,000, including all related sub-tasks u) $24,403,536 u) $24,403,536 u) $24,403,536 u) $24,403,536 u) $24,403,536 n) Fixed price for monthly call volume at least 450% greater than 56,000, including all related sub-tasks v) $25,392,993 v) $25,392,993 v) $25,392,993 v) $25,392,993 v) $25,392,993 a) Fixed price for monthly call volume up to 56,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 8.6 AND 12.0 MINUTES PER CALL a) $7,434,194 a) $7,434,194 a) $7,434,194 a) $7,434,194 a) $7,434,194 b) Fixed price for monthly call volume at least 10% greater than 56,000, including all related sub-tasks b) $7,868,763 b) $7,868,763 b) $7,868,763 b) $7,868,763 b) $7,868,763 c) Fixed price for monthly call volume at least 20% greater than 56,000, including all related sub-tasks c) $8,520,128 c) $8,520,128 c) $8,520,128 c) $8,520,128 c) $8,520,128 d) Fixed price for monthly call volume at least 30% greater than 56,000, including all related sub-tasks d) $9,150,872 d) $9,150,872 d) $9,150,872 d) $9,150,872 d) $9,150,872 e) Fixed price for monthly call volume at least 40% greater than 56,000, including all related sub-tasks e) $9,909,523 e) $9,909,523 e) $9,909,523 e) $9,909,523 e) $9,909,523 f) Fixed price for monthly call volume at least 50% greater than 56,000, including all related sub-tasks f) $10,653,951 f) $10,653,951 f) $10,653,951 f) $10,653,951 f) $10,653,951 g) Fixed price for monthly call volume at least 75% greater than 56,000, including all related sub-tasks g) $12,373,432 g) $12,373,432 g) $12,373,432 g) $12,373,432 g) $12,373,432 h) Fixed price for monthly call volume at least 100% greater than 56,000, including all related sub-tasks h) $14,129,449 h) $14,129,449 h) $14,129,449 h) $14,129,449 h) $14,129,449 i) Fixed price for monthly call volume at least 130% greater than 56,000, including all related sub-tasks i) $16,301,516 i) $16,301,516 i) $16,301,516 i) $16,301,516 i) $16,301,516 j) Fixed price for monthly call volume at least 150% greater than 56,000, including all related sub-tasks j) $17,711,974 j) $17,711,974 j) $17,711,974 j) $17,711,974 j) $17,711,974 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 3 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Reference Method k) Fixed price for monthly call volume at least 175% greater than 56,000, including all related sub-tasks Year Price (12 months) k) $19,291,736 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year k) $19,291,736 Third Year Price k) $19,291,736 Fourth Year Price Fifth Year Price k) $19,291,736 k) $19,291,736 Page 4 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Beneficiary Helpline (includes MI Health Care Helpline calls) Reference Method l) Fixed price for monthly call volume at least 200% greater than 56,000, including all related sub-tasks Year Third Fourth Year Price Year Price Fifth Year Price l) $20,839,249 l) $20,839,249 l) $20,839,249 l) $20,839,249 m) Fixed price for monthly call volume at least 225% greater than 56,000, including all related sub-tasks m) $22,355,007 m) $22,355,007 m) $22,355,007 m) $22,355,007 m) $22,355,007 n) Fixed price for monthly call volume at least 250% greater than 56,000, including all related sub-tasks n) $23,839,494 n) $23,839,494 n) $23,839,494 n) $23,839,494 n) $23,839,494 o) Fixed price for monthly call volume at least 275% greater than 56,000, including all related sub-tasks o) $25,315,083 o) $25,315,083 o) $25,315,083 o) $25,315,083 o) $25,315,083 p) Fixed price for monthly call volume at least 300% greater than 56,000, including all related sub-tasks p) $26,751,743 p) $26,751,743 p) $26,751,743 p) $26,751,743 p) $26,751,743 q) Fixed price for monthly call volume at least 325% greater than 56,000, including all related sub-tasks q) $28,157,240 q) $28,157,240 q) $28,157,240 q) $28,157,240 q) $28,157,240 n) Fixed price for monthly call volume at least 350% greater than 56,000, including all related sub-tasks r) $29,531,572 r) $29,531,572 r) $29,531,572 r) $29,531,572 r) $29,531,572 n) Fixed price for monthly call volume at least 375% greater than 56,000, including all related sub-tasks s) $30,933,952 s) $30,933,952 s) $30,933,952 s) $30,933,952 s) $30,933,952 n) Fixed price for monthly call volume at least 400% greater than 56,000, including all related sub-tasks t) $32,373,729 t) $32,373,729 t) $32,373,729 t) $32,373,729 t) $32,373,729 n) Fixed price for monthly call volume at least 425% greater than 56,000, including all related sub-tasks u) $33,729,363 u) $33,729,363 u) $33,729,363 u) $33,729,363 u) $33,729,363 n) Fixed price for monthly call volume at least 450% greater than 56,000, including all related sub-tasks v) $35,128,627 v) $35,128,627 v) $35,128,627 v) $35,128,627 v) $35,128,627 1.022.A Fixed price for MONTHLY operation - MICHIGAN only 1.022.A Price per call minute connected to a live agent (includes ACA Beneficiary Helpline) Beneficiary Helpline - ACA related Extended Call Center Hours of Operation Business Continuity 1.022.A Price per call minute connected to a live agent (includes CMS phone application services) Fixed price for MONTHLY operation of extended call center hours Price per call minute connected to a live agent 1.022.A.3 Second Price l) $20,839,249 Beneficiary Helpline - ACA related Beneficiary Helpline - ACA related 1.022.A.2 Year Price (12 months) $ 87,894 Included in Beneficiary Helpline Volume $ 87,894 $ Included in Beneficiary Helpline Volume 87,894 $ Included in Beneficiary Helpline Volume 87,894 $ 87,894 Included in Included in Beneficiary Beneficiary Helpline Volume Helpline Volume $ 0.720 $ 0.720 $ 0.720 $ 0.720 $ 0.720 $ 49,283 $ 49,283 $ 49,283 $ 49,283 $ 49,283 $ 0.776 $ 0.776 $ 0.776 $ 0.776 $ 0.776 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 5 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Health Plan Enrollment Information, Education and Assistance Reference 1.022.B Method a) Fixed price for monthly enrollment information, education and assistance for up to 70,000 transactions, including all related sub-tasks BASED ON UP TO 6.5 MINUTES PER CALL FOR ENROLLMENT CALLS Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $4,275,005 a) $4,275,005 a) $4,275,005 a) $4,275,005 a) $4,275,005 b) Fixed price for monthly enrollment information, education and assistance volume at least 10% greater than 70,000 transactions, including all related sub-tasks b) $4,376,274 b) $4,376,274 b) $4,376,274 b) $4,376,274 b) $4,376,274 c) Fixed price for monthly enrollment information, education and assistance volume at least 20% greater than 70,000 transactions, including all related sub-tasks c) $4,544,756 c) $4,544,756 c) $4,544,756 c) $4,544,756 c) $4,544,756 d) Fixed price for monthly enrollment information, education and assistance volume at least 30% greater than 70,000 transactions, including all related sub-tasks d) $4,738,498 d) $4,738,498 d) $4,738,498 d) $4,738,498 d) $4,738,498 e) Fixed price for monthly enrollment information, education and assistance volume at least 40% greater than 70,000 transactions, including all related sub-tasks e) $5,043,583 e) $5,043,583 e) $5,043,583 e) $5,043,583 e) $5,043,583 f) Fixed price for monthly enrollment information, education and assistance volume at least 50% greater than 70,000 transactions, including all related sub-tasks f) $5,274,756 f) $5,274,756 f) $5,274,756 f) $5,274,756 f) $5,274,756 g) Fixed price for monthly enrollment information, education and assistance volume at least 75% greater than 70,000 transactions, including all related sub-tasks g) $5,499,479 g) $5,499,479 g) $5,499,479 g) $5,499,479 g) $5,499,479 h) Fixed price for monthly enrollment information, education and assistance volume at least 100% greater than 70,000 transactions, including all related sub-tasks h) $5,769,902 h) $5,769,902 h) $5,769,902 h) $5,769,902 h) $5,769,902 i) Fixed price for monthly enrollment information, education and assistance volume at least 125% greater than 70,000 transactions, including all related sub-tasks i) $6,032,486 i) $6,032,486 i) $6,032,486 i) $6,032,486 i) $6,032,486 j) Fixed price for monthly enrollment information, education and assistance volume at least 150% greater than 70,000 transactions, including all related sub-tasks j) $6,305,660 j) $6,305,660 j) $6,305,660 j) $6,305,660 j) $6,305,660 k) Fixed price for monthly enrollment information, education and assistance volume at least 175% greater than 70,000 transactions, including all related sub-tasks k) $6,589,883 k) $6,589,883 k) $6,589,883 k) $6,589,883 k) $6,589,883 l) Fixed price for monthly enrollment information, education and assistance volume at least 200% greater than 70,000 transactions, including all related sub-tasks l) $6,885,638 l) $6,885,638 l) $6,885,638 l) $6,885,638 l) $6,885,638 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 6 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Health Plan Enrollment Information, Education and Assistance Reference 1.022.B Method a2) Fixed price for monthly enrollment information, education and assistance for up to 70,000 transactions, including all related sub-tasks BASED ON AVERAGE CALLS LENGHTS BETWEEN 6.6 AND 9.5 MINUTES PER ENROLLMENT CALL Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $4,917,773 a) $4,917,773 a) $4,917,773 a) $4,917,773 a) $4,917,773 b2) Fixed price for monthly enrollment information, education and assistance volume at least 10% greater than 70,000 transactions, including all related sub-tasks b) $5,092,690 b) $5,092,690 b) $5,092,690 b) $5,092,690 b) $5,092,690 c2) Fixed price for monthly enrollment information, education and assistance volume at least 20% greater than 70,000 transactions, including all related sub-tasks c) $5,334,365 c) $5,334,365 c) $5,334,365 c) $5,334,365 c) $5,334,365 d2) Fixed price for monthly enrollment information, education and assistance volume at least 30% greater than 70,000 transactions, including all related sub-tasks d) $5,571,994 d) $5,571,994 d) $5,571,994 d) $5,571,994 d) $5,571,994 e2) Fixed price for monthly enrollment information, education and assistance volume at least 40% greater than 70,000 transactions, including all related sub-tasks e) $6,041,080 e) $6,041,080 e) $6,041,080 e) $6,041,080 e) $6,041,080 f2) Fixed price for monthly enrollment information, education and assistance volume at least 50% greater than 70,000 transactions, including all related sub-tasks f) $6,403,411 f) $6,403,411 f) $6,403,411 f) $6,403,411 f) $6,403,411 g2) Fixed price for monthly enrollment information, education and assistance volume at least 75% greater than 70,000 transactions, including all related sub-tasks g) $6,767,057 g) $6,767,057 g) $6,767,057 g) $6,767,057 g) $6,767,057 h2) Fixed price for monthly enrollment information, education and assistance volume at least 100% greater than 70,000 transactions, including all related sub-tasks h) $7,141,226 h) $7,141,226 h) $7,141,226 h) $7,141,226 h) $7,141,226 i2) Fixed price for monthly enrollment information, education and assistance volume at least 125% greater than 70,000 transactions, including all related sub-tasks i) $7,542,478 i) $7,542,478 i) $7,542,478 i) $7,542,478 i) $7,542,478 j2) Fixed price for monthly enrollment information, education and assistance volume at least 150% greater than 70,000 transactions, including all related sub-tasks j) $7,955,418 j) $7,955,418 j) $7,955,418 j) $7,955,418 j) $7,955,418 k2) Fixed price for monthly enrollment information, education and assistance volume at least 175% greater than 70,000 transactions, including all related sub-tasks k) $8,398,436 k) $8,398,436 k) $8,398,436 k) $8,398,436 k) $8,398,436 l2) Fixed price for monthly enrollment information, education and assistance volume at least 200% greater than 70,000 transactions, including all related sub-tasks l) $8,854,435 l) $8,854,435 l) $8,854,435 l) $8,854,435 l) $8,854,435 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 7 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Health Plan Enrollment Information, Education and Assistance Automated Enrollment / Disenrollment Reference 1.022.B 1.022.C Method a3) Fixed price for monthly enrollment information, education and assistance for up to 70,000 transactions, including all related sub-tasks BASED ON AVERAGE CALLS LENGHTS BETWEEN 9.6 AND 13 MINUTES PER ENROLLMENT CALL Second Price Year Price (12 months) Year Third Fourth Year Price Year Price Fifth Year Price a) $5,552,435 a) $5,552,435 a) $5,552,435 a) $5,552,435 a) $5,552,435 b3) Fixed price for monthly enrollment information, education and assistance volume at least 10% greater than 70,000 transactions, including all related sub-tasks b) $5,808,726 b) $5,808,726 b) $5,808,726 b) $5,808,726 b) $5,808,726 c3) Fixed price for monthly enrollment information, education and assistance volume at least 20% greater than 70,000 transactions, including all related sub-tasks c) $6,131,321 c) $6,131,321 c) $6,131,321 c) $6,131,321 c) $6,131,321 d3) Fixed price for monthly enrollment information, education and assistance volume at least 30% greater than 70,000 transactions, including all related sub-tasks d) $6,450,063 d) $6,450,063 d) $6,450,063 d) $6,450,063 d) $6,450,063 e3) Fixed price for monthly enrollment information, education and assistance volume at least 40% greater than 70,000 transactions, including all related sub-tasks e) $7,031,198 e) $7,031,198 e) $7,031,198 e) $7,031,198 e) $7,031,198 f3) Fixed price for monthly enrollment information, education and assistance volume at least 50% greater than 70,000 transactions, including all related sub-tasks f) $7,473,203 f) $7,473,203 f) $7,473,203 f) $7,473,203 f) $7,473,203 g3) Fixed price for monthly enrollment information, education and assistance volume at least 75% greater than 70,000 transactions, including all related sub-tasks g) $7,968,517 g) $7,968,517 g) $7,968,517 g) $7,968,517 g) $7,968,517 h3) Fixed price for monthly enrollment information, education and assistance volume at least 100% greater than 70,000 transactions, including all related sub-tasks h) $8,474,254 h) $8,474,254 h) $8,474,254 h) $8,474,254 h) $8,474,254 i3) Fixed price for monthly enrollment information, education and assistance volume at least 125% greater than 70,000 transactions, including all related sub-tasks i) $9,029,095 i) $9,029,095 i) $9,029,095 i) $9,029,095 i) $9,029,095 j3) Fixed price for monthly enrollment information, education and assistance volume at least 150% greater than 70,000 transactions, including all related sub-tasks j) $9,595,703 j) $9,595,703 j) $9,595,703 j) $9,595,703 j) $9,595,703 k3) Fixed price for monthly enrollment information, education and assistance volume at least 175% greater than 70,000 transactions, including all related sub-tasks k) $10,217,740 k) $10,217,740 k) $10,217,740 k) $10,217,740 k) $10,217,740 l3) Fixed price for monthly enrollment information, education and assistance volume at least 200% greater than 70,000 transactions, including all related sub-tasks l) $10,853,061 l) $10,853,061 l) $10,853,061 l) $10,853,061 l) $10,853,061 Fixed price for development and implementation of the algorithm to allow for the monthly automated enrollment and disenrollment process $0 $0 $0 $0 $0 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 8 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Mailing Services Reference 1.022.D Method Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings. Up to 93,425 mailings Year Price (12 months) Second Price Year Third Fourth Year Price Year Price Fifth Year Price $ 1,551,860 $ 1,551,860 $ 1,551,860 $ 1,551,860 $ 1,551,860 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 10% greater than 93,425 mailings $ 1,616,404 $ 1,616,404 $ 1,616,404 $ 1,616,404 $ 1,616,404 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 20% greater than 93,425 mailings $ 1,744,177 $ 1,744,177 $ 1,744,177 $ 1,744,177 $ 1,744,177 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 30% greater than 93,425 mailings $ 1,871,949 $ 1,871,949 $ 1,871,949 $ 1,871,949 $ 1,871,949 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 40% greater than 93,425 mailings $ 2,001,189 $ 2,001,189 $ 2,001,189 $ 2,001,189 $ 2,001,189 $ 2,132,070 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 50% greater than 93,425 mailings $ 2,132,070 $ 2,132,070 $ 2,132,070 $ 2,132,070 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 75% greater than 93,425 mailings $ 2,459,272 $ 2,459,272 $ 2,459,272 $ 2,459,272 $ 2,459,272 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 100% greater than 93,425 mailings $ 2,786,475 $ 2,786,475 $ 2,786,475 $ 2,786,475 $ 2,786,475 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 125% greater than 93,425 mailings $ 3,158,703 $ 3,158,703 $ 3,158,703 $ 3,158,703 $ 3,158,703 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 150% greater than 93,425 mailings $ 3,483,010 $ 3,483,010 $ 3,483,010 $ 3,483,010 $ 3,483,010 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 175% greater than 93,425 mailings $ 3,801,986 $ 3,801,986 $ 3,801,986 $ 3,801,986 $ 3,801,986 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 200% greater than 93,425 mailings $ 4,115,630 $ 4,115,630 $ 4,115,630 $ 4,115,630 $ 4,115,630 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 225% greater than 93,425 mailings $ 4,423,942 $ 4,423,942 $ 4,423,942 $ 4,423,942 $ 4,423,942 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 9 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Reference Method Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 250% greater than 93,425 mailings Year Price (12 months) $ 4,726,922 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price $ Year 4,726,922 $ Third Fourth Year Price Year Price 4,726,922 $ 4,726,922 $ Fifth Year Price 4,726,922 Page 10 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Mailing Services Mailing Services UNIT PRICING Reference 1.022.D 1.022.D Mailing Services (After 1557 Implementation) 1.022.D Method Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 275% greater than 93,425 mailings Second Price Year Price (12 months) Year Third Fourth Year Price Year Price Fifth Year Price $ 5,024,570 $ 5,024,570 $ 5,024,570 $ 5,024,570 $ 5,024,570 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 300% greater than 93,425 mailings $ 5,316,887 $ 5,316,887 $ 5,316,887 $ 5,316,887 $ 5,316,887 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 325% greater than 93,425 mailings $ 5,603,871 $ 5,603,871 $ 5,603,871 $ 5,603,871 $ 5,603,871 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 350% greater than 93,425 mailings $ 5,885,524 $ 5,885,524 $ 5,885,524 $ 5,885,524 $ 5,885,524 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 375% greater than 93,425 mailings $ 6,161,844 $ 6,161,844 $ 6,161,844 $ 6,161,844 $ 6,161,844 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 400% greater than 93,425 mailings $ 6,486,152 $ 6,486,152 $ 6,486,152 $ 6,486,152 $ 6,486,152 Healthy Michigan Plan (HMP) Handbook/Brochure: PRICE PER MAILING $ 1.34 $ 1.34 $ 1.34 $ 1.34 $ 1.34 HMP HRA Survey Inserts: PRICE PER INSERT ONLY (mailing included in tiers above) $ 0.97 $ 0.97 $ 0.97 $ 0.97 $ 0.97 Other Insurance and Medicare related mailings: PRICE PER MAILING MIHA Hearing Packets (Garnishments): PRICE PER MAILING $ 1.43 $ 1.43 $ 1.43 $ 1.43 $ 1.43 $ 1.34 $ 1.34 $ 1.34 $ 1.34 $ 1.34 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings. Up to 93,425 mailings $ 1,672,966 $ 1,672,966 $ 1,672,966 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 10% greater than 93,425 mailings $ 1,749,622 $ 1,749,622 $ 1,749,622 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 20% greater than 93,425 mailings $ 1,889,505 $ 1,889,505 $ 1,889,505 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 30% greater than 93,425 mailings $ 2,029,388 $ 2,029,388 $ 2,029,388 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 40% greater than 93,425 mailings $ 2,170,738 $ 2,170,738 $ 2,170,738 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 50% greater than 93,425 mailings $ 2,313,730 $ 2,313,730 $ 2,313,730 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 11 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Reference Method Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 75% greater than 93,425 mailings Year Price (12 months) MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Year Price $ 2,671,209 $ Fourth Year Price 2,671,209 Fifth Year Price $ 2,671,209 Page 12 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Reference Method Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 100% greater than 93,425 mailings Year Price (12 months) Second Price Year Third Fourth Year Price Year Price Fifth Year Price $ 3,028,688 $ 3,028,688 $ 3,028,688 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 125% greater than 93,425 mailings $ 3,431,194 $ 3,431,194 $ 3,431,194 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 150% greater than 93,425 mailings $ 3,785,778 $ 3,785,778 $ 3,785,778 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 175% greater than 93,425 mailings $ 4,135,030 $ 4,135,030 $ 4,135,030 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 200% greater than 93,425 mailings $ 4,478,951 $ 4,478,951 $ 4,478,951 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 225% greater than 93,425 mailings $ 4,817,539 $ 4,817,539 $ 4,817,539 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 250% greater than 93,425 mailings $ 5,150,796 $ 5,150,796 $ 5,150,796 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 275% greater than 93,425 mailings $ 5,478,720 $ 5,478,720 $ 5,478,720 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 300% greater than 93,425 mailings $ 5,801,314 $ 5,801,314 $ 5,801,314 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 325% greater than 93,425 mailings $ 6,118,575 $ 6,118,575 $ 6,118,575 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 350% greater than 93,425 mailings $ 6,430,504 $ 6,430,504 $ 6,430,504 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 375% greater than 93,425 mailings $ 6,737,102 $ 6,737,102 $ 6,737,102 Fixed price for monthly mailings across all types except that a separate piece rate is required for special mailings – at least 400% greater than 93,425 mailings $ 7,091,686 $ 7,091,686 $ 7,091,686 Other Insurance and Medicare related mailings: PRICE PER MAILING Tag Line Inserts PRICE PER INSERT MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx $1.54 $1.54 $1.54 $0.04 $0.04 $0.04 Page 13 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Outreach and Cooperation with Agencies Reference 1.022.E Second Price Year Price (12 months) Method $ 1,383,778 $ Year Third Fourth Year Price Year Price 1,383,778 Fifth Year Price $ 1,383,778 $ 1,383,778 $ 1,383,778 Fixed monthly price Outreach and Cooperation with Agencies Familiarity with Health Plans Health Care Program Administration a) Administrative Support for colocated DHS staff, including space used for call center operations. Fixed monthly price for the number of Medicaid beneficiaries that are mandatory for enrollment that is at least 10% more than mandatory beneficiaries as of April 1, 2011 $ 1,483,057 $ 1,483,057 $ 1,483,057 $ 1,483,057 $ 1,483,057 Fixed monthly price for the number of Medicaid beneficiaries that are mandatory for enrollment that is at least 20% more than mandatory beneficiaries as of April 1, 2011 $ 1,582,337 $ 1,582,337 $ 1,582,337 $ 1,582,337 $ 1,582,337 Fixed monthly price for the number of Medicaid beneficiaries that are mandatory for enrollment that is at least 30% more than mandatory beneficiaries as of April 1, 2011 $ 1,681,616 $ 1,681,616 $ 1,681,616 $ 1,681,616 $ 1,681,616 Fixed monthly price for the number of Medicaid beneficiaries that are mandatory for enrollment that is at least 40% more than mandatory beneficiaries as of April 1, 2011 $ 1,794,525 $ 1,794,525 $ 1,794,525 $ 1,794,525 $ 1,794,525 $ 0.25 $ 0.25 $ 0.25 $ 0.25 $ 0.25 Outreach Event Participation PRICE PER EVENT $ 500.00 $ 500.00 $ 500.00 $ 500.00 $ 500.00 Outreach Mailings PRICE PER MAILING $ 1.10 $ 1.10 $ 1.10 $ 1.10 $ Automated Outbound Outreach Calls PRICE PER CALL 1.022.F Fixed monthly price $ 2,158 $ 2,158 $ 2,158 $ 2,158 $ 1.10 2,158 1.022.G & 1.022.M a) Fixed price for monthly support of required sub-tasks – bidder may include volume tiers or other quantity measures for pricing a) $190,690 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx a) $190,690 a) $190,690 a) $190,690 a) $190,690 Page 14 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component b) MIChild and Healthy Kids Medicaid b) MIChild and Healthy Kids Medicaid Reference 1.022.G & 1.022.M Year Price (12 months) Method Second Price Year Third Year Price Fourth Year Price Fifth Year Price b1.1) Fixed price for monthly call volume up to 6,000, including all related sub-tasks BASED ON AN AVERAGE CALL LENGTH UP TO 5.5 MINUTES b1.1) $251,014 b1.1) $251,014 b1.1) $251,014 b1.1) $251,014 b1.2) Fixed price for monthly call volume at least 10% greater than 6,000, including all related sub-tasks b1.2) $265,889 b1.2) $265,889 b1.2) $265,889 b1.2) $265,889 b1.3) Fixed price for monthly call volume at least 20% greater than 6,000, including all related sub-tasks b1.3) $290,261 b1.3) $290,261 b1.3) $290,261 b1.3) $290,261 b1.4) Fixed price for monthly call volume at least 30% greater than 6,000, including all related sub-tasks b1.4) $318,479 b1.4) $318,479 b1.4) $318,479 b1.4) $318,479 b1.5) Fixed price for monthly call volume at least 40% greater than 6,000, including all related sub-tasks b1.5) $339,448 b1.5) $339,448 b1.5) $339,448 b1.5) $339,448 b1.6) Fixed price for monthly call volume at least 75% greater than 6,000, including all related sub-tasks b1.6) $359,387 b1.6) $359,387 b1.6) $359,387 b1.6) $359,387 b1.7) Fixed price for monthly call volume at least 100% greater than 6,000, including all related sub-tasks b1.7) $474,207 b1.7) $474,207 b1.7) $474,207 b1.7) $474,207 b1.1) Fixed price for monthly call volume up to 6,000, including all related sub-tasks BASED ON AN AVERAGE CALL LENGTH BETWEEN 5.6 MINUTES AND 8.5 MINUTES PER CALL b1.1) $349,952 b1.1) $349,952 b1.1) $349,952 b1.1) $349,952 b1.2) Fixed price for monthly call volume at least 10% greater than 6,000, including all related sub-tasks b1.2) $377,211 b1.2) $377,211 b1.2) $377,211 b1.2) $377,211 b1.3) Fixed price for monthly call volume at least 20% greater than 6,000, including all related sub-tasks b1.3) $413,906 b1.3) $413,906 b1.3) $413,906 b1.3) $413,906 b1.4) Fixed price for monthly call volume at least 30% greater than 6,000, including all related sub-tasks b1.4) $442,197 b1.4) $442,197 b1.4) $442,197 b1.4) $442,197 b1.5) Fixed price for monthly call volume at least 40% greater than 6,000, including all related sub-tasks b1.5) $487738 b1.5) $487738 b1.5) $487738 b1.5) $487738 b1.6) Fixed price for monthly call volume at least 75% greater than 6,000, including all related sub-tasks b1.6) $507,830 b1.6) $507,830 b1.6) $507,830 b1.6) $507,830 b1.7) Fixed price for monthly call volume at least 100% greater than 6,000, including all related sub-tasks b1.7) $684,374 b1.7) $684,374 b1.7) $684,374 b1.7) $684,374 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 15 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component b) MIChild and Healthy Kids Medicaid e) Program-related mailings Reference Year Price (12 months) Method Second Price Year Third Year Price Fourth Year Price Fifth Year Price b1.1) Fixed price for monthly call volume up to 6,000, including all related sub-tasks BASED ON AN AVERAGE CALL LENGTH BETWEEN 8.6 MINUTES AND 11 MINUTES PER CALL b1.1) $413,371 b1.1) $413,371 b1.1) $413,371 b1.1) $413,371 b1.2) Fixed price for monthly call volume at least 10% greater than 6,000, including all related sub-tasks b1.2) $453,060 b1.2) $453,060 b1.2) $453,060 b1.2) $453,060 b1.3) Fixed price for monthly call volume at least 20% greater than 6,000, including all related sub-tasks b1.3) $502,112 b1.3) $502,112 b1.3) $502,112 b1.3) $502,112 b1.4) Fixed price for monthly call volume at least 30% greater than 6,000, including all related sub-tasks b1.4) $542,835 b1.4) $542,835 b1.4) $542,835 b1.4) $542,835 b1.5) Fixed price for monthly call volume at least 40% greater than 6,000, including all related sub-tasks b1.5) $576,470 b1.5) $576,470 b1.5) $576,470 b1.5) $576,470 b1.6) Fixed price for monthly call volume at least 75% greater than 6,000, including all related sub-tasks b1.6) $615,981 b1.6) $615,981 b1.6) $615,981 b1.6) $615,981 b1.7) Fixed price for monthly call volume at least 100% greater than 6,000, including all related sub-tasks b1.7) $823,313 b1.7) $823,313 b1.7) $823,313 b1.7) $823,313 e) $111,722 e) $111,722 e) $111,722 e) $111,722 e.1) $117,124 e.1) $117,124 e.1) $117,124 e.1) $117,124 e.2) $128,278 e.2) $128,278 e.2) $128,278 e.2) $128,278 e.3) $139,433 e.3) $139,433 e.3) $139,433 e.3) $139,433 e.4) $150,587 e.4) $150,587 e.4) $150,587 e.4) $150,587 e.5) $161,741 e.5) $161,741 e.5) $161,741 e.5) $161,741 e.6) $181,819 e.6) $181,819 e.6) $181,819 e.6) $181,819 e.7) $209,706 e.7) $209,706 e.7) $209,706 e.7) $209,706 e.8) $235,919 e.8) $235,919 e.8) $235,919 e.8) $235,919 e.9) $262,132 e.9) $262,132 e.9) $262,132 e.9) $262,132 e.10) $288,345 e.10) $288,345 e.10) $288,345 e.10) $288,345 e) Fixed monthly price for all related sub-tasks up to 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 10% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 20% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 30% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 40% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 50% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 75% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 100% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 125% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 150% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 175% greater than 8,000 including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 16 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component e) Program-related mailings Reference e) Program-related mailings (After 1557 Implementation) h) MI Health Link (Integrated Care) Record Retention h) MI Health Link (Integrated Care) Record Retention Online Application System (MIChild Online / DCT) Method Fixed price for MIChild Mailings monthly volumes at least 200% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 225% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 250% greater than 8,000 including all related sub-tasks ACA Missing Information Letter PRICE PER MAILING ACA Eligibility Decision Letter PRICE PER MAILING Redetermination Mailing (additional charge due to ACA changes) PRICE PER PACKET e) Fixed monthly price for all related sub-tasks up to 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 10% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 20% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 30% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 40% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 50% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 75% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 100% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 125% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 150% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 175% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 200% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 225% greater than 8,000 including all related sub-tasks Fixed price for MIChild Mailings monthly volumes at least 250% greater than 8,000 including all related sub-tasks 1.022.G ACA Missing Information Letter PRICE PER MAILING ACA Eligibility Decision Letter PRICE PER MAILING Redetermination Mailing (additional charge due to ACA changes) PRICE PER PACKET Fixed monthly price 1.022.G Fixed monthly price (per each TB of storage space) 1.022.H Fixed annual price Second Price Year Price (12 months) $ $ $ $ 1.43 1.43 1.12 1,051 $93,180 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx $ $ $ Year Third Year Price Fourth Year Price Fifth Year Price e.11) $314,559 e.11) $314,559 e.11) $314,559 e.11) $314,559 e.12) $340,772 e.12) $340,772 e.12) $340,772 e.12) $340,772 e.13) $366,985 e.13) $366,985 e.13) $366,985 e.13) $366,985 1.43 1.43 1.12 $ $ $ 1.43 $ 1.43 $ 1.12 $ 1.43 1.43 1.12 $ $ $ 1.43 1.43 1.12 e) $122,092 e) $122,092 e) $122,092 e.1) $123,129 e.1) $123,129 e.1) $123,129 e.2) $124,166 e.2) $124,166 e.2) $124,166 e.3) $125,204 e.3) $125,204 e.3) $125,204 e.4) $126,241 e.4) $126,241 e.4) $126,241 e.5) $127,278 e.5) $127,278 e.5) $127,278 e.6) $129,870 e.6) $129,870 e.6) $129,870 e.7) $132,463 e.7) $132,463 e.7) $132,463 e.8) $135,055 e.8) $135,055 e.8) $135,055 3.9) $137,648 3.9) $137,648 3.9) $137,648 e.10) $140,241 e.10) $140,241 e.10) $140,241 e.11) $142,833 e.11) $142,833 e.11) $142,833 e.12) $145,426 e.12) $145,426 e.12) $145,426 e.13) $148,018 e.13) $148,018 e.13) $148,018 $1.54 $1.54 $1.23 $1.54 $1.54 $1.23 $1.54 $1.54 $1.23 $ 1,051 $ 1,051 $ 1,051 $ 1,051 $ 726 $ 726 $ 726 $ 726 $93,180 $93,180 $93,180 $93,180 Page 17 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Online Presumptive Application Web Services Penetration Testing Interactive Voice Response System Premium Collection – MIChild Premium Collection – FTW Medicaid Reference Method 1.022.H.a Fixed annual price 1.022.H.b Fixed price per occurance 1.022.I 1.022.J.1 1.022.J.2 Year Price (12 months) $106,848 Fixed annual price Second Price Year Third Year Price Fourth Year Price Fifth Year Price $106,848 $106,848 $106,848 $106,848 $11,070 $11,070 $11,070 $11,070 $51,767 a) $383,695 $51,767 a) $383,695 $51,767 a) $383,695 $51,767 a) $383,695 $51,767 a) $383,695 b) Fixed price for monthly premium volume at least 10% greater than 22,000, including all related sub-tasks b) $386,138 b) $386,138 b) $386,138 b) $386,138 b) $386,138 c) Fixed price for monthly premium volume at least 20% greater than 22,000, including all related sub-tasks d) Fixed price for monthly premium volume at least 30% greater than 22,000, including all related sub-tasks c) $393,239 c) $393,239 c) $393,239 c) $393,239 c) $393,239 d) $400,340 d) $400,340 d) $400,340 d) $400,340 d) $400,340 a) Fixed price for monthly premium volume up to 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 10% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 20% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 30% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 40% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 50% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 75% greater than 2,000, including all related sub-tasks a) $104,930 a) $104,930 a) $104,930 a) $104,930 b) $106,730 b) $106,730 b) $106,730 b) $106,730 c) $108,530 c) $108,530 c) $108,530 c) $108,530 d) $110,330 d) $110,330 d) $110,330 d) $110,330 e) $112,130 e) $112,130 e) $112,130 e) $112,130 f) $113,930 f) $113,930 f) $113,930 f) $113,930 g) $118,430 g) $118,430 g) $118,430 g) $118,430 b) Fixed price for monthly premium volume at least 100% greater than 2,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 125% greater than 2,000, including all related sub-tasks h) $122,930 h) $122,930 h) $122,930 h) $122,930 i) $127,430 i) $127,430 i) $127,430 i) $127,430 b) Fixed price for monthly premium volume at least 150% greater than 2,000, including all related sub-tasks j) $131,930 j) $131,930 j) $131,930 j) $131,930 b) Fixed price for monthly premium volume at least 175% greater than 2,000, including all related sub-tasks k) $136,430 k) $136,430 k) $136,430 k) $136,430 b) Fixed price for monthly premium volume at least 200% greater than 2,000, including all related sub-tasks l) $140,930 l) $140,930 l) $140,930 l) $140,930 a) Fixed price for monthly premium volume up to 22,000, including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 18 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Premium Collection – MI Marketplace Option Premiums Research Support mihealth Card Service Reference 1.022.J.3 1.022.J.4 1.022.K Year Price (12 months) Method a) Fixed price for monthly premium volume up to 6,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 10% greater than 6,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 20% greater than 6,000, including all related sub-tasks b) Fixed price for monthly premium volume at least 30% greater than 6,000, including all related sub-tasks 1.022.Q Year Third Year Price Fourth Year Price Fifth Year Price a) $236,606 a) $236,606 a) $236,606 a) $236,606 a) $236,606 b) $237,833 b) $237,833 b) $237,833 b) $237,833 b) $237,833 c) $239,059 c) $239,059 c) $239,059 c) $239,059 c) $239,059 d) $240,285 d) $240,285 d) $240,285 d) $240,285 d) $240,285 a) Fixed Price for monthly support of Department Reviews and Administrative Hearings volumes up to 1,500 cases a)$131,461 a)$131,461 a)$131,461 a)$131,461 b) Fixed Price for monthly support of Department Reviews and Administrative Hearings volumes at least 50% greater than 1,500 cases b)$196,777 b)$196,777 b)$196,777 b)$196,777 a) Fixed price for monthly card volume up to 470,000, including all related sub-tasks a) $610,531 a) $610,531 a) $610,531 a) $610,531 a) $610,531 b) Fixed price for monthly card volume at least 10% greater than 470,000, including all related sub-tasks b) $638,106 b) $638,106 b) $638,106 b) $638,106 b) $638,106 c) $1.23 c) $1.23 c) $1.23 c) $1.23 c) $1.23 2.879 0.200 $2.879 $0.200 $2.879 $0.200 $2.879 $0.200 c) UNIT PRICE per card for annual card volumes that exceed 517,000 (Change Notice No. 4) Health Risk Assessment or MI Health Link / Integrated Care Initial Screening Second Price Call Center Completed Survey PRICE PER SURVEY Automated Service Completed Survey PRICE PER SURVEY $ $ 2.879 0.200 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx $ $ Page 19 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services (Including Nursing Facility Transition) Reference 1.022.Q.b Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 8.5 MINUTES PER CALL b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $2,003,089 a) $2,003,089 a) $2,003,089 a) $2,003,089 a) $2,003,089 b) $2,155,568 b) $2,155,568 b) $2,155,568 b) $2,155,568 b) $2,155,568 c) $2,308,047 c) $2,308,047 c) $2,308,047 c) $2,308,047 c) $2,308,047 d) $2,602,930 d) $2,602,930 d) $2,602,930 d) $2,602,930 d) $2,602,930 e) $2,755,410 e) $2,755,410 e) $2,755,410 e) $2,755,410 e) $2,755,410 f) $2,907,889 f) $2,907,889 f) $2,907,889 f) $2,907,889 f) $2,907,889 g) $3,060,367 g) $3,060,367 g) $3,060,367 g) $3,060,367 g) $3,060,367 h) $3,212,846 h) $3,212,846 h) $3,212,846 h) $3,212,846 h) $3,212,846 i) $3,507,730 i) $3,507,730 i) $3,507,730 i) $3,507,730 i) $3,507,730 j) $3,660,209 j) $3,660,209 j) $3,660,209 j) $3,660,209 j) $3,660,209 k) $3,812,688 k) $3,812,688 k) $3,812,688 k) $3,812,688 k) $3,812,688 l) $4,757,444 l) $4,757,444 l) $4,757,444 l) $4,757,444 l) $4,757,444 m) $5,086,239 m) $5,086,239 m) $5,086,239 m) $5,086,239 m) $5,086,239 n) $5,676,552 n) $5,676,552 n) $5,676,552 n) $5,676,552 n) $5,676,552 o) $6,061,764 o) $6,061,764 o) $6,061,764 o) $6,061,764 o) $6,061,764 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 20 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services (Including Nursing Facility Transition) Reference 1.022.Q.b Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 8.6 AND 12 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $2,756,468 a) $2,756,468 a) $2,756,468 a) $2,756,468 a) $2,756,468 b) $3,008,306 b) $3,008,306 b) $3,008,306 b) $3,008,306 b) $3,008,306 c) $3,212,316 c) $3,212,316 c) $3,212,316 c) $3,212,316 c) $3,212,316 d) $3,558,733 d) $3,558,733 d) $3,558,733 d) $3,558,733 d) $3,558,733 e) $3,762,744 e) $3,762,744 e) $3,762,744 e) $3,762,744 e) $3,762,744 f) $4,014,582 f) $4,014,582 f) $4,014,582 f) $4,014,582 f) $4,014,582 g) $4,360,997 g) $4,360,997 g) $4,360,997 g) $4,360,997 g) $4,360,997 h) $4,565,008 h) $4,565,008 h) $4,565,008 h) $4,565,008 h) $4,565,008 i) $4,769,020 i) $4,769,020 i) $4,769,020 i) $4,769,020 i) $4,769,020 j) $4,973,031 j) $4,973,031 j) $4,973,031 j) $4,973,031 j) $4,973,031 k) $5,367,273 k) $5,367,273 k) $5,367,273 k) $5,367,273 k) $5,367,273 l) $6,446,691 l) $6,446,691 l) $6,446,691 l) $6,446,691 l) $6,446,691 m) $7,091,708 m) $7,091,708 m) $7,091,708 m) $7,091,708 m) $7,091,708 n) $7,795,139 n) $7,795,139 n) $7,795,139 n) $7,795,139 n) $7,795,139 o) $8,396,599 o) $8,396,599 o) $8,396,599 o) $8,396,599 o) $8,396,599 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 21 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services (Including Nursing Facility Transition) Provider Services Reference 1.022.Q.b 1.022.Q.b1 Year Price (12 months) Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 12.1 AND 16 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks MONTHLY price for mail services $ Second Price Year Third Fourth Year Price Year Price Fifth Year Price a) $3,610,795 a) $3,610,795 a) $3,610,795 a) $3,610,795 a) $3,610,795 b) $3,914,694 b) $3,914,694 b) $3,914,694 b) $3,914,694 b) $3,914,694 c) $4,360,997 c) $4,360,997 c) $4,360,997 c) $4,360,997 c) $4,360,997 d) $4,617,070 d) $4,617,070 d) $4,617,070 d) $4,617,070 d) $4,617,070 e) $4,920,969 e) $4,920,969 e) $4,920,969 e) $4,920,969 e) $4,920,969 f) $5,367,273 f) $5,367,273 f) $5,367,273 f) $5,367,273 f) $5,367,273 g) $5,623,345 g) $5,623,345 g) $5,623,345 g) $5,623,345 g) $5,623,345 h) $5,927,244 h) $5,927,244 h) $5,927,244 h) $5,927,244 h) $5,927,244 i) $6,373,548 i) $6,373,548 i) $6,373,548 i) $6,373,548 i) $6,373,548 j) $6,629,621 j) $6,629,621 j) $6,629,621 j) $6,629,621 j) $6,629,621 k) $7,075,924 k) $7,075,924 k) $7,075,924 k) $7,075,924 k) $7,075,924 l) $8,713,962 l) $8,713,962 l) $8,713,962 l) $8,713,962 l) $8,713,962 m) $9,317,705 m) $9,317,705 m) $9,317,705 m) $9,317,705 m) $9,317,705 n) $10,238,811 n) $10,238,811 n) $10,238,811 n) $10,238,811 n) $10,238,811 o) $11,159,917 o) $11,159,917 o) $11,159,917 o) $11,159,917 o) $11,159,917 1,063 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx $ 1,063 $ 1,063 $ 1,063 $ 1,063 Page 22 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services - Part 2 Reference 1.022.Q.b2 Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 10.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $4,177,162 a) $4,177,162 a) $4,177,162 a) $4,177,162 a) $4,177,162 b) $4,533,052 b) $4,533,052 b) $4,533,052 b) $4,533,052 b) $4,533,052 c) $4,898,726 c) $4,898,726 c) $4,898,726 c) $4,898,726 c) $4,898,726 d) $5,254,617 d) $5,254,617 d) $5,254,617 d) $5,254,617 d) $5,254,617 e) $5,543,533 e) $5,543,533 e) $5,543,533 e) $5,543,533 e) $5,543,533 f) $6,085,614 f) $6,085,614 f) $6,085,614 f) $6,085,614 f) $6,085,614 g) $6,448,298 g) $6,448,298 g) $6,448,298 g) $6,448,298 g) $6,448,298 h) $6,804,188 h) $6,804,188 h) $6,804,188 h) $6,804,188 h) $6,804,188 i) $7,169,863 i) $7,169,863 i) $7,169,863 i) $7,169,863 i) $7,169,863 j) $7,525,753 j) $7,525,753 j) $7,525,753 j) $7,525,753 j) $7,525,753 k) $7,891,427 k) $7,891,427 k) $7,891,427 k) $7,891,427 k) $7,891,427 l) $8,968,883 l) $8,968,883 l) $8,968,883 l) $8,968,883 l) $8,968,883 m) $9,613,690 m) $9,613,690 m) $9,613,690 m) $9,613,690 m) $9,613,690 n) $10,589,145 n) $10,589,145 n) $10,589,145 n) $10,589,145 n) $10,589,145 o) $11,455,168 o) $11,455,168 o) $11,455,168 o) $11,455,168 o) $11,455,168 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 23 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services - Part 2 Reference 1.022.Q.b2 Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 10.1 AND 15.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $6,085,614 a) $6,085,614 a) $6,085,614 a) $6,085,614 a) $6,085,614 b) $6,518,988 b) $6,518,988 b) $6,518,988 b) $6,518,988 b) $6,518,988 c) $7,096,095 c) $7,096,095 c) $7,096,095 c) $7,096,095 c) $7,096,095 d) $7,596,444 d) $7,596,444 d) $7,596,444 d) $7,596,444 d) $7,596,444 e) $8,173,551 e) $8,173,551 e) $8,173,551 e) $8,173,551 e) $8,173,551 f) $8,606,925 f) $8,606,925 f) $8,606,925 f) $8,606,925 f) $8,606,925 g) $9,257,799 g) $9,257,799 g) $9,257,799 g) $9,257,799 g) $9,257,799 h) $9,944,338 h) $9,944,338 h) $9,944,338 h) $9,944,338 h) $9,944,338 i) $10,444,687 i) $10,444,687 i) $10,444,687 i) $10,444,687 i) $10,444,687 j) $10,954,819 j) $10,954,819 j) $10,954,819 j) $10,954,819 j) $10,954,819 k) $11,455,168 k) $11,455,168 k) $11,455,168 k) $11,455,168 k) $11,455,168 l) $13,042,755 l) $13,042,755 l) $13,042,755 l) $13,042,755 l) $13,042,755 m) $14,229,643 m) $14,229,643 m) $14,229,643 m) $14,229,643 m) $14,229,643 n) $15,600,544 n) $15,600,544 n) $15,600,544 n) $15,600,544 n) $15,600,544 o) $16,894,687 o) $16,894,687 o) $16,894,687 o) $16,894,687 o) $16,894,687 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 24 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Provider Services - Part 2 Reference 1.022.Q.b2 Method a) Fixed price for monthly call volume up to 25,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 15.1 AND 20.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 25,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 25,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 25,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 25,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 25,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 25,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 25,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 25,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 25,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 25,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 25,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 25,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 25,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 25,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $7,817,660 a) $7,817,660 a) $7,817,660 a) $7,817,660 a) $7,817,660 b) $8,462,467 b) $8,462,467 b) $8,462,467 b) $8,462,467 b) $8,462,467 c) $9,184,032 c) $9,184,032 c) $9,184,032 c) $9,184,032 c) $9,184,032 d) $10,015,029 d) $10,015,029 d) $10,015,029 d) $10,015,029 d) $10,015,029 e) $10,736,593 e) $10,736,593 e) $10,736,593 e) $10,736,593 e) $10,736,593 f) $11,381,400 f) $11,381,400 f) $11,381,400 f) $11,381,400 f) $11,381,400 g) $12,176,733 g) $12,176,733 g) $12,176,733 g) $12,176,733 g) $12,176,733 h) $12,898,297 h) $12,898,297 h) $12,898,297 h) $12,898,297 h) $12,898,297 i) $13,729,294 i) $13,729,294 i) $13,729,294 i) $13,729,294 i) $13,729,294 j) $14,374,101 j) $14,374,101 j) $14,374,101 j) $14,374,101 j) $14,374,101 k) $15,095,666 k) $15,095,666 k) $15,095,666 k) $15,095,666 k) $15,095,666 l) $17,183,603 l) $17,183,603 l) $17,183,603 l) $17,183,603 l) $17,183,603 m) $18,736,164 m) $18,736,164 m) $18,736,164 m) $18,736,164 m) $18,736,164 n) $20,535,185 n) $20,535,185 n) $20,535,185 n) $20,535,185 n) $20,535,185 o) $22,376,663 o) $22,376,663 o) $22,376,663 o) $22,376,663 o) $22,376,663 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 25 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component DHHS Call Center Support Reference 1.022.Q.c Method a) Fixed price for monthly call volume up to 17,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 3.0 MINUTES PER CALL b) Fixed price for monthly call volume at least 10% greater than 17,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 17,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 17,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 17,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 17,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 17,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 17,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 17,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 17,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 17,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 17,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 17,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 17,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 17,000, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 17,000, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 17,000, including all related sub-tasks r) Fixed price for monthly call volume at least 275% greater than 17,000, including all related sub-tasks s) Fixed price for monthly call volume at least 300% greater than 17,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $902,818 a) $902,818 a) $902,818 a) $902,818 a) $902,818 b) $959,526 b) $959,526 b) $959,526 b) $959,526 b) $959,526 c) $1,016,234 c) $1,016,234 c) $1,016,234 c) $1,016,234 c) $1,016,234 d) $1,072,941 d) $1,072,941 d) $1,072,941 d) $1,072,941 d) $1,072,941 e) $1,129,650 e) $1,129,650 e) $1,129,650 e) $1,129,650 e) $1,129,650 f) $1,186,357 f) $1,186,357 f) $1,186,357 f) $1,186,357 f) $1,186,357 g) $1,191,344 g) $1,191,344 g) $1,191,344 g) $1,191,344 g) $1,191,344 h) $1,248,051 h) $1,248,051 h) $1,248,051 h) $1,248,051 h) $1,248,051 i) $1,304,760 i) $1,304,760 i) $1,304,760 i) $1,304,760 i) $1,304,760 j) $1,361,467 j) $1,361,467 j) $1,361,467 j) $1,361,467 j) $1,361,467 k) $1,646,788 k) $1,646,788 k) $1,646,788 k) $1,646,788 k) $1,646,788 l) $1,958,934 l) $1,958,934 l) $1,958,934 l) $1,958,934 l) $1,958,934 m) $2,081,215 m) $2,081,215 m) $2,081,215 m) $2,081,215 m) $2,081,215 n) $2,268,357 n) $2,268,357 n) $2,268,357 n) $2,268,357 n) $2,268,357 o) $2,393,326 o) $2,393,326 o) $2,393,326 o) $2,393,326 o) $2,393,326 p) $2,518,295 p) $2,518,295 p) $2,518,295 p) $2,518,295 p) $2,518,295 q) $2,763,866 q) $2,763,866 q) $2,763,866 q) $2,763,866 q) $2,763,866 r) $2,888,835 r) $2,888,835 r) $2,888,835 r) $2,888,835 r) $2,888,835 s) $3,013,805 s) $3,013,805 s) $3,013,805 s) $3,013,805 s) $3,013,805 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 26 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component DHHS Call Center Support Reference 1.022.Q.c Method a) Fixed price for monthly call volume up to 17,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 3.1 AND 6 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 17,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 17,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 17,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 17,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 17,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 17,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 17,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 17,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 17,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 17,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 17,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 17,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 17,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 17,000, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 17,000, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 17,000, including all related sub-tasks r) Fixed price for monthly call volume at least 275% greater than 17,000, including all related sub-tasks s) Fixed price for monthly call volume at least 300% greater than 17,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $1,646,788 a) $1,646,788 a) $1,646,788 a) $1,646,788 a) $1,646,788 b) $1,760,204 b) $1,760,204 b) $1,760,204 b) $1,760,204 b) $1,760,204 c) $1,873,620 c) $1,873,620 c) $1,873,620 c) $1,873,620 c) $1,873,620 d) $1,935,314 d) $1,935,314 d) $1,935,314 d) $1,935,314 d) $1,935,314 e) $2,048,730 e) $2,048,730 e) $2,048,730 e) $2,048,730 e) $2,048,730 f) $2,162,145 f) $2,162,145 f) $2,162,145 f) $2,162,145 f) $2,162,145 g) $2,275,561 g) $2,275,561 g) $2,275,561 g) $2,275,561 g) $2,275,561 h) $2,449,113 h) $2,449,113 h) $2,449,113 h) $2,449,113 h) $2,449,113 i) $2,510,807 i) $2,510,807 i) $2,510,807 i) $2,510,807 i) $2,510,807 j) $2,624,223 j) $2,624,223 j) $2,624,223 j) $2,624,223 j) $2,624,223 k) $2,737,640 k) $2,737,640 k) $2,737,640 k) $2,737,640 k) $2,737,640 l) $3,324,884 l) $3,324,884 l) $3,324,884 l) $3,324,884 l) $3,324,884 m) $3,634,283 m) $3,634,283 m) $3,634,283 m) $3,634,283 m) $3,634,283 n) $3,939,986 n) $3,939,986 n) $3,939,986 n) $3,939,986 n) $3,939,986 o) $4,436,407 o) $4,436,407 o) $4,436,407 o) $4,436,407 o) $4,436,407 p) $4,742,110 p) $4,742,110 p) $4,742,110 p) $4,742,110 p) $4,742,110 q) $4,992,049 q) $4,992,049 q) $4,992,049 q) $4,992,049 q) $4,992,049 r) $5,362,589 r) $5,362,589 r) $5,362,589 r) $5,362,589 r) $5,362,589 s) $5,612,527 s) $5,612,527 s) $5,612,527 s) $5,612,527 s) $5,612,527 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 27 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component DHHS Call Center Support Reference 1.022.Q.c Method a) Fixed price for monthly call volume up to 17,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 6.1 AND 9.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 17,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 17,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 17,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 17,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 17,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 17,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 17,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 17,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 17,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 17,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 17,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 17,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 17,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 17,000, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 17,000, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 17,000, including all related sub-tasks r) Fixed price for monthly call volume at least 275% greater than 17,000, including all related sub-tasks s) Fixed price for monthly call volume at least 300% greater than 17,000, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $2,162,145 a) $2,162,145 a) $2,162,145 a) $2,162,145 a) $2,162,145 b) $2,392,406 b) $2,392,406 b) $2,392,406 b) $2,392,406 b) $2,392,406 c) $2,510,807 c) $2,510,807 c) $2,510,807 c) $2,510,807 c) $2,510,807 d) $2,680,931 d) $2,680,931 d) $2,680,931 d) $2,680,931 d) $2,680,931 e) $2,851,055 e) $2,851,055 e) $2,851,055 e) $2,851,055 e) $2,851,055 f) $3,021,178 f) $3,021,178 f) $3,021,178 f) $3,021,178 f) $3,021,178 g) $3,199,717 g) $3,199,717 g) $3,199,717 g) $3,199,717 g) $3,199,717 h) $3,369,841 h) $3,369,841 h) $3,369,841 h) $3,369,841 h) $3,369,841 i) $3,539,964 i) $3,539,964 i) $3,539,964 i) $3,539,964 i) $3,539,964 j) $3,716,032 j) $3,716,032 j) $3,716,032 j) $3,716,032 j) $3,716,032 k) $4,114,767 k) $4,114,767 k) $4,114,767 k) $4,114,767 k) $4,114,767 l) $4,930,908 l) $4,930,908 l) $4,930,908 l) $4,930,908 l) $4,930,908 m) $5,362,589 m) $5,362,589 m) $5,362,589 m) $5,362,589 m) $5,362,589 n) $5,737,496 n) $5,737,496 n) $5,737,496 n) $5,737,496 n) $5,737,496 o) $6,382,143 o) $6,382,143 o) $6,382,143 o) $6,382,143 o) $6,382,143 p) $6,907,015 p) $6,907,015 p) $6,907,015 p) $6,907,015 p) $6,907,015 q) $7,489,969 q) $7,489,969 q) $7,489,969 q) $7,489,969 q) $7,489,969 r) $7,864,877 r) $7,864,877 r) $7,864,877 r) $7,864,877 r) $7,864,877 s) $8,360,387 s) $8,360,387 s) $8,360,387 s) $8,360,387 s) $8,360,387 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 28 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component DHHS Call Center Support MDHHS Call Center Universal Case Load Supplemental Services Reference 1.022.Q.c 1.022.Q.c.1 Second Price Year Price (12 months) Method a) Fixed price for monthly call volume up to 17,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 9.1 AND 12.0 MINUTES PER CALL. Year Third Fourth Year Price Year Price Fifth Year Price a) $3,013,805 a) $3,013,805 a) $3,013,805 a) $3,013,805 a) $3,013,805 b) $3,258,367 b) $3,258,367 b) $3,258,367 b) $3,258,367 b) $3,258,367 c) $3,512,002 c) $3,512,002 c) $3,512,002 c) $3,512,002 c) $3,512,002 d) $3,756,564 d) $3,756,564 d) $3,756,564 d) $3,756,564 d) $3,756,564 e) $3,945,362 e) $3,945,362 e) $3,945,362 e) $3,945,362 e) $3,945,362 f) $4,436,407 f) $4,436,407 f) $4,436,407 f) $4,436,407 f) $4,436,407 g) $4,680,969 g) $4,680,969 g) $4,680,969 g) $4,680,969 g) $4,680,969 h) $4,869,767 h) $4,869,767 h) $4,869,767 h) $4,869,767 h) $4,869,767 i) $5,114,330 i) $5,114,330 i) $5,114,330 i) $5,114,330 i) $5,114,330 j) $5,367,965 j) $5,367,965 j) $5,367,965 j) $5,367,965 j) $5,367,965 k) $5,612,527 k) $5,612,527 k) $5,612,527 k) $5,612,527 k) $5,612,527 l) $6,417,459 l) $6,417,459 l) $6,417,459 l) $6,417,459 l) $6,417,459 m) $7,097,302 m) $7,097,302 m) $7,097,302 m) $7,097,302 m) $7,097,302 n) $7,652,943 n) $7,652,943 n) $7,652,943 n) $7,652,943 n) $7,652,943 o) $8,360,387 o) $8,360,387 o) $8,360,387 o) $8,360,387 o) $8,360,387 p) $8,980,865 p) $8,980,865 p) $8,980,865 p) $8,980,865 p) $8,980,865 q) $9,845,161 q) $9,845,161 q) $9,845,161 q) $9,845,161 q) $9,845,161 r) $10,400,803 r) $10,400,803 r) $10,400,803 r) $10,400,803 r) $10,400,803 s) $11,021,281 s) $11,021,281 s) $11,021,281 s) $11,021,281 s) $11,021,281 b) Fixed price for monthly call volume at least 10% greater than 17,000, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 17,000, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 17,000, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 17,000, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 17,000, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 17,000, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 17,000, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 17,000, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 17,000, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 17,000, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 17,000, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 17,000, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 17,000, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 17,000, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 17,000, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 17,000, including all related sub-tasks r) Fixed price for monthly call volume at least 275% greater than 17,000, including all related sub-tasks s) Fixed price for monthly call volume at least 300% greater than 17,000, including all related sub-tasks Paper Application Reprint Requests PRICE PER MAIL PIECE $ 1.38 $ 1.38 $ 1.38 $ 1.38 $ 1.38 IVR Support Translation Spanish PRICE PER WORD $ 0.22 $ 0.22 $ 0.22 $ 0.22 $ 0.22 IVR Support Translation Arabic PRICE PER WORD $ 0.31 $ 0.31 $ 0.31 $ 0.31 $ 0.31 DTP Formatting PRICE PER HOUR $ 82.00 $ 82.00 $ 82.00 $ 82.00 $ 82.00 English Translation of Script for IVR PRICE PER HOUR $ 442.00 $ 442.00 $ 442.00 $ 442.00 $ 442.00 Spanish Translation of Script for IVR PRICE PER HOUR $ 442.00 $ 442.00 $ 442.00 $ 442.00 $ 442.00 Arabic Translation of Script for IVR PRICE PER HOUR $ 620.00 $ 620.00 $ 620.00 $ 620.00 $ 620.00 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 29 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component CHL Alacart Services Reference 1.022.Q.c.2 Method Readability - Paper Materials, Cat 1 – Readability review and proposed edits for 1 existing notice/document 1-2 pages Readability - Paper Materials, Cat 2 – Readability review and proposed edits for 1 existing notice/document 3-4 pages Readability - Paper Materials, Cat 3 – Readability review and proposed edits for 1 existing lnotice/document 5-6 pages, 1 comparison chart Year Price (12 months) Second Price Year Third Fourth Year Price Year Price Fifth Year Price $664 $664 $664 $664 $996 $996 $996 $996 $1,162 $1,162 $1,162 $1,162 Readablity - Digital, Cat 1 – Readability review and proposed edits for 1 existing website or mobile app or set of SMS/email notifications (0-10 pages) $1,494 $1,494 $1,494 $1,494 Readability - Digital, Cat 2 – Readability review and proposed edits for 1 existing website or mobile app or set of SMS/email notifications(10-20 pages) $1,992 $1,992 $1,992 $1,992 Readability - Digital, Cat 3 – Readability review and proposed edits for 1 existing website or mobile app or set of SMS/email notifications (20-30 pages), 1 comparison chart $2,988 $2,988 $2,988 $2,988 $498 $498 $498 $498 $830 $830 $830 $830 $1,162 $1,162 $1,162 $1,162 Design - Digital, Cat 1 – Design review and comments for 1 existing website or mobile app or set of SMS/email notifications (0-2 pages) $498 $498 $498 $498 Design - Digital, Cat 2 – Design review and comments for 1 existing website or mobile app or set of SMS/email notifications (3-4 pages) $664 $664 $664 $664 Design - Digital, Cat 3 – Design review and comments for 1 existing website or mobile app or set of SMS/email notifications (5-7 pages) $996 $996 $996 $996 Design - Digital, Cat 4 – Design review and comments for 1 existing website or mobile app or set of SMS/email notifications (8-10 pages), 1 comparison chart $1,328 $1,328 $1,328 $1,328 Design - Digital, Cat 5 – Design review and mockups for 1 existing website or mobile app or set of SMS/email notifications (0-2 pages) $830 $830 $830 $830 Design - Digital, Cat 6 – Design review and mockups for 1 existing website or mobile app or set of SMS/email notifications (3-4 pages) $1,328 $1,328 $1,328 $1,328 Design - Digital, Cat 7 – Design review and mockups for 1 existing website or mobile app or set of SMS/email notifications (5-7 pages) $2,324 $2,324 $2,324 $2,324 Design - Digital, Cat 8 – Design review and mockups for 1 existing website or mobile app or set of SMS/email notifications (8-10 pages), 1 comparison chart $3,320 $3,320 $3,320 $3,320 Accessibility, Cat 1 – Accessibility audit and summary report on 1 website, with up to 2 languages $8,298 $8,298 $8,298 $8,298 Design - Paper Materials, Cat 1 – Design review and/or update 1 existing notice/document 1-2 pages Design - Paper Materials, Cat 2 – Design review and/or update 1 existing notice/document 3-4 pages Design - Paper Materials, Cat 3 – Design review and/or update 1 existing notice/document 5-6 pages, 1 comparison chart MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 30 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Health Risk Assessment Unit Health Risk Assessment Unit Reference 1.022.Q.d 1.022.Q.d Method Accessibility, Cat 2 – Accessibility consulting and remediation guidance, up to 100 hours a) Fixed price for monthly call volume up to 1,500, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 10.0 MINUTES PER CALL Year Price (12 months) b) Fixed price for monthly call volume at least 25% greater than 1,500, including all related sub-tasks c) Fixed price for monthly call volume at least 50% greater than 1,500, including all related sub-tasks d) Fixed price for monthly call volume at least 75% greater than 1,500, including all related sub-tasks e) Fixed price for monthly call volume at least 100% greater than 1,500, including all related sub-tasks f) Fixed price for monthly call volume at least 125% greater than 1,500, including all related sub-tasks g) Fixed price for monthly call volume at least 150% greater than 1,500, including all related sub-tasks h) Fixed price for monthly call volume at least 175% greater than 1,500, including all related sub-tasks i) Fixed price for monthly call volume at least 200% greater than 1,500, including all related sub-tasks j) Fixed price for monthly call volume at least 225% greater than 1,500, including all related sub-tasks k) Fixed price for monthly call volume at least 250% greater than 1,500, including all related sub-tasks a) Fixed price for monthly call volume up to 1,500, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 10.1 AND 15.0 MINUTES PER CALL b) Fixed price for monthly call volume at least 25% greater than 1,500, including all related sub-tasks c) Fixed price for monthly call volume at least 50% greater than 1,500, including all related sub-tasks d) Fixed price for monthly call volume at least 75% greater than 1,500, including all related sub-tasks e) Fixed price for monthly call volume at least 100% greater than 1,500, including all related sub-tasks f) Fixed price for monthly call volume at least 125% greater than 1,500, including all related sub-tasks g) Fixed price for monthly call volume at least 150% greater than 1,500, including all related sub-tasks h) Fixed price for monthly call volume at least 175% greater than 1,500, including all related sub-tasks i) Fixed price for monthly call volume at least 200% greater than 1,500, including all related sub-tasks j) Fixed price for monthly call volume at least 225% greater than 1,500, including all related sub-tasks k) Fixed price for monthly call volume at least 250% greater than 1,500, including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Year Price Fourth Year Price Fifth Year Price $16,596 $16,596 $16,596 $16,596 a) $517,415 a) $517,415 a) $517,415 a) $517,415 b) $641,131 b) $641,131 b) $641,131 b) $641,131 c) $764,846 c) $764,846 c) $764,846 c) $764,846 d) $766,129 d) $766,129 d) $766,129 d) $766,129 e) $889,845 e) $889,845 e) $889,845 e) $889,845 f) $1,013,560 f) $1,013,560 f) $1,013,560 f) $1,013,560 g) $1,137,276 g) $1,137,276 g) $1,137,276 g) $1,137,276 h) $1,138,559 h) $1,138,559 h) $1,138,559 h) $1,138,559 i) $1,262,274 i) $1,262,274 i) $1,262,274 i) $1,262,274 j) $1,530,975 j) $1,530,975 j) $1,530,975 j) $1,530,975 k) $1,654,691 k) $1,654,691 k) $1,654,691 k) $1,654,691 a) $764,846 a) $764,846 a) $764,846 a) $764,846 b) $889,203 b) $889,203 b) $889,203 b) $889,203 c) $1,013,560 c) $1,013,560 c) $1,013,560 c) $1,013,560 d) $1,137,917 d) $1,137,917 d) $1,137,917 d) $1,137,917 e) $1,262,274 e) $1,262,274 e) $1,262,274 e) $1,262,274 f) $1,531,617 f) $1,531,617 f) $1,531,617 f) $1,531,617 g) $1,655,974 g) $1,655,974 g) $1,655,974 g) $1,655,974 h) $1,780,331 h) $1,780,331 h) $1,780,331 h) $1,780,331 i) $2,027,120 i) $2,027,120 i) $2,027,120 i) $2,027,120 j) $2,151,477 j) $2,151,477 j) $2,151,477 j) $2,151,477 k) $2,275,834 k) $2,275,834 k) $2,275,834 k) $2,275,834 Page 31 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component ISD Portal Support Pilot ISD Portal Support Pilot Reference 1.022.R 1.022.R Method a) Fixed price for monthly call volume up to 250, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 10.0 MINUTES PER CALL b) Fixed price for monthly call volume at least 100% greater than 250, including all related sub-tasks c) Fixed price for monthly call volume at least 200% greater than 250, including all related sub-tasks d) Fixed price for monthly call volume at least 300% greater than 250, including all related sub-tasks e) Fixed price for monthly call volume at least 400% greater than 250, including all related sub-tasks f) Fixed price for monthly call volume at least 500% greater than 250, including all related sub-tasks g) Fixed price for monthly call volume at least 600% greater than 250, including all related sub-tasks h) Fixed price for monthly call volume at least 700% greater than 250, including all related sub-tasks i) Fixed price for monthly call volume at least 800% greater than 250, including all related sub-tasks j) Fixed price for monthly call volume at least 900% greater than 250, including all related sub-tasks k) Fixed price for monthly call volume at least 1000% greater than 250, including all related sub-tasks a) Fixed price for monthly call volume up to 250, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 10.1 AND 15.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 100% greater than 250, including all related sub-tasks c) Fixed price for monthly call volume at least 200% greater than 250, including all related sub-tasks d) Fixed price for monthly call volume at least 300% greater than 250, including all related sub-tasks e) Fixed price for monthly call volume at least 400% greater than 250, including all related sub-tasks f) Fixed price for monthly call volume at least 500% greater than 250, including all related sub-tasks g) Fixed price for monthly call volume at least 600% greater than 250, including all related sub-tasks h) Fixed price for monthly call volume at least 700% greater than 250, including all related sub-tasks i) Fixed price for monthly call volume at least 800% greater than 250, including all related sub-tasks j) Fixed price for monthly call volume at least 900% greater than 250, including all related sub-tasks k) Fixed price for monthly call volume at least 1000% greater than 250, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $352,373 a) $352,373 a) $352,373 a) $352,373 a) $352,373 b) $430,946 b) $430,946 b) $430,946 b) $430,946 b) $430,946 c) $509,518 c) $509,518 c) $509,518 c) $509,518 c) $509,518 d) $588,091 d) $588,091 d) $588,091 d) $588,091 d) $588,091 e) $666,664 e) $666,664 e) $666,664 e) $666,664 e) $666,664 f) $745,236 f) $745,236 f) $745,236 f) $745,236 f) $745,236 g) $823,809 g) $823,809 g) $823,809 g) $823,809 g) $823,809 h) $902,382 h) $902,382 h) $902,382 h) $902,382 h) $902,382 i) $980,954 i) $980,954 i) $980,954 i) $980,954 i) $980,954 j) $1,059,527 j) $1,059,527 j) $1,059,527 j) $1,059,527 j) $1,059,527 k) $1,138,100 k) $1,138,100 k) $1,138,100 k) $1,138,100 k) $1,138,100 a) $421,197 a) $421,197 a) $421,197 a) $421,197 a) $421,197 b) $568,594 b) $568,594 b) $568,594 b) $568,594 b) $568,594 c) $715,991 c) $715,991 c) $715,991 c) $715,991 c) $715,991 d) $863,388 d) $863,388 d) $863,388 d) $863,388 d) $863,388 e) $1,010,785 e) $1,010,785 e) $1,010,785 e) $1,010,785 e) $1,010,785 f) $1,158,182 f) $1,158,182 f) $1,158,182 f) $1,158,182 f) $1,158,182 g) $1,368,573 g) $1,368,573 g) $1,368,573 g) $1,368,573 g) $1,368,573 h) $1,583,471 h) $1,583,471 h) $1,583,471 h) $1,583,471 h) $1,583,471 i) $1,730,868 i) $1,730,868 i) $1,730,868 i) $1,730,868 i) $1,730,868 j) $1,878,264 j) $1,878,264 j) $1,878,264 j) $1,878,264 j) $1,878,264 k) $2,025,661 k) $2,025,661 k) $2,025,661 k) $2,025,661 k) $2,025,661 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 32 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component ISD Portal Support Pilot Reference 1.022.R Method a) Fixed price for monthly call volume up to 250, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 15.1 AND 20.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 100% greater than 250, including all related sub-tasks c) Fixed price for monthly call volume at least 200% greater than 250, including all related sub-tasks d) Fixed price for monthly call volume at least 300% greater than 250, including all related sub-tasks e) Fixed price for monthly call volume at least 400% greater than 250, including all related sub-tasks f) Fixed price for monthly call volume at least 500% greater than 250, including all related sub-tasks g) Fixed price for monthly call volume at least 600% greater than 250, including all related sub-tasks h) Fixed price for monthly call volume at least 700% greater than 250, including all related sub-tasks i) Fixed price for monthly call volume at least 800% greater than 250, including all related sub-tasks j) Fixed price for monthly call volume at least 900% greater than 250, including all related sub-tasks k) Fixed price for monthly call volume at least 1000% greater than 250, including all related sub-tasks Paper Application Reprint Requests PRICE PER MAIL PIECE Second Price Year Price (12 months) $ Year Third Fourth Year Price Year Price Fifth Year Price a) $549,097 a) $549,097 a) $549,097 a) $549,097 a) $549,097 b) $706,242 b) $706,242 b) $706,242 b) $706,242 b) $706,242 c) $863,388 c) $863,388 c) $863,388 c) $863,388 c) $863,388 d) $1,020,533 d) $1,020,533 d) $1,020,533 d) $1,020,533 d) $1,020,533 e) $1,177,679 e) $1,177,679 e) $1,177,679 e) $1,177,679 e) $1,177,679 f) $1,397,818 f) $1,397,818 f) $1,397,818 f) $1,397,818 f) $1,397,818 g) $1,622,465 g) $1,622,465 g) $1,622,465 g) $1,622,465 g) $1,622,465 h) $1,779,610 h) $1,779,610 h) $1,779,610 h) $1,779,610 h) $1,779,610 i) $1,936,755 i) $1,936,755 i) $1,936,755 i) $1,936,755 i) $1,936,755 j) $2,157,837 j) $2,157,837 j) $2,157,837 j) $2,157,837 j) $2,157,837 k) $2,407,179 k) $2,407,179 k) $2,407,179 k) $2,407,179 k) $2,407,179 1.38 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx $ 1.38 $ 1.38 $ 1.38 $ 1.38 Page 33 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component ISD Portal Support Reference 1.022.R.1 Method a) Fixed price for monthly call volume up to 22,500, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 10.0 MINUTES PER CALL b) Fixed price for monthly call volume at least 10% greater than 22,500, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 22,500, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 22,500, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 22,500, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 22,500, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 22,500, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 22,500, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 22,500, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 22,500, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 22,500, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 22,500, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 22,500, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 22,500, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 22,500, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 22,500, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 22,500, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $2,834,744 a) $2,834,744 a) $2,834,744 a) $2,834,744 a) $2,834,744 b) $3,083,947 b) $3,083,947 b) $3,083,947 b) $3,083,947 b) $3,083,947 c) $3,344,964 c) $3,344,964 c) $3,344,964 c) $3,344,964 c) $3,344,964 d) $3,594,167 d) $3,594,167 d) $3,594,167 d) $3,594,167 d) $3,594,167 e) $3,843,369 e) $3,843,369 e) $3,843,369 e) $3,843,369 e) $3,843,369 f) $4,248,221 f) $4,248,221 f) $4,248,221 f) $4,248,221 f) $4,248,221 g) $4,441,737 g) $4,441,737 g) $4,441,737 g) $4,441,737 g) $4,441,737 h) $4,690,939 h) $4,690,939 h) $4,690,939 h) $4,690,939 h) $4,690,939 i) $5,007,643 i) $5,007,643 i) $5,007,643 i) $5,007,643 i) $5,007,643 j) $5,201,159 j) $5,201,159 j) $5,201,159 j) $5,201,159 j) $5,201,159 k) $5,450,362 k) $5,450,362 k) $5,450,362 k) $5,450,362 k) $5,450,362 l) $6,365,917 l) $6,365,917 l) $6,365,917 l) $6,365,917 l) $6,365,917 m) $7,019,971 m) $7,019,971 m) $7,019,971 m) $7,019,971 m) $7,019,971 n) $7,654,792 n) $7,654,792 n) $7,654,792 n) $7,654,792 n) $7,654,792 o) $8,222,112 o) $8,222,112 o) $8,222,112 o) $8,222,112 o) $8,222,112 p) $8,856,933 p) $8,856,933 p) $8,856,933 p) $8,856,933 p) $8,856,933 q) $9,791,721 q) $9,791,721 q) $9,791,721 q) $9,791,721 q) $9,791,721 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 34 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component ISD Portal Support Reference 1.022.R.1 Method a) Fixed price for monthly call volume up to 22,500, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 10.1 AND 15.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 22,500, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 22,500, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 22,500, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 22,500, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 22,500, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 22,500, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 22,500, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 22,500, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 22,500, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 22,500, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 22,500, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 22,500, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 22,500, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 22,500, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 22,500, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 22,500, including all related sub-tasks Year Price (12 months) Second Price Year Third Year Price Fourth Year Price Fifth Year Price a) $4,184,284 a) $4,184,284 a) $4,184,284 a) $4,184,284 a) $4,184,284 b) $4,502,402 b) $4,502,402 b) $4,502,402 b) $4,502,402 b) $4,502,402 c) $4,943,707 c) $4,943,707 c) $4,943,707 c) $4,943,707 c) $4,943,707 d) $5,261,824 d) $5,261,824 d) $5,261,824 d) $5,261,824 d) $5,261,824 e) $5,795,325 e) $5,795,325 e) $5,795,325 e) $5,795,325 e) $5,795,325 f) $6,113,443 f) $6,113,443 f) $6,113,443 f) $6,113,443 f) $6,113,443 g) $6,487,247 g) $6,487,247 g) $6,487,247 g) $6,487,247 g) $6,487,247 h) $6,961,013 h) $6,961,013 h) $6,961,013 h) $6,961,013 h) $6,961,013 i) $7,334,817 i) $7,334,817 i) $7,334,817 i) $7,334,817 i) $7,334,817 j) $7,720,435 j) $7,720,435 j) $7,720,435 j) $7,720,435 j) $7,720,435 k) $8,094,239 k) $8,094,239 k) $8,094,239 k) $8,094,239 k) $8,094,239 l) $9,578,972 l) $9,578,972 l) $9,578,972 l) $9,578,972 l) $9,578,972 m) $10,426,542 m) $10,426,542 m) $10,426,542 m) $10,426,542 m) $10,426,542 n) $11,435,860 n) $11,435,860 n) $11,435,860 n) $11,435,860 n) $11,435,860 o) $12,470,333 o) $12,470,333 o) $12,470,333 o) $12,470,333 o) $12,470,333 p) $13,517,103 p) $13,517,103 p) $13,517,103 p) $13,517,103 p) $13,517,103 q) $14,463,427 q) $14,463,427 q) $14,463,427 q) $14,463,427 q) $14,463,427 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 35 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component ISD Portal Support Reference 1.022.R.1 Method a) Fixed price for monthly call volume up to 22,500, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 15.1 AND 20.0 MINUTES PER CALL. b) Fixed price for monthly call volume at least 10% greater than 22,500, including all related sub-tasks c) Fixed price for monthly call volume at least 20% greater than 22,500, including all related sub-tasks d) Fixed price for monthly call volume at least 30% greater than 22,500, including all related sub-tasks e) Fixed price for monthly call volume at least 40% greater than 22,500, including all related sub-tasks f) Fixed price for monthly call volume at least 50% greater than 22,500, including all related sub-tasks g) Fixed price for monthly call volume at least 60% greater than 22,500, including all related sub-tasks h) Fixed price for monthly call volume at least 70% greater than 22,500, including all related sub-tasks i) Fixed price for monthly call volume at least 80% greater than 22,500, including all related sub-tasks j) Fixed price for monthly call volume at least 90% greater than 22,500, including all related sub-tasks k) Fixed price for monthly call volume at least 100% greater than 22,500, including all related sub-tasks l) Fixed price for monthly call volume at least 130% greater than 22,500, including all related sub-tasks m) Fixed price for monthly call volume at least 150% greater than 22,500, including all related sub-tasks n) Fixed price for monthly call volume at least 175% greater than 22,500, including all related sub-tasks o) Fixed price for monthly call volume at least 200% greater than 22,500, including all related sub-tasks p) Fixed price for monthly call volume at least 225% greater than 22,500, including all related sub-tasks q) Fixed price for monthly call volume at least 250% greater than 22,500, including all related sub-tasks Paper Application Reprint Requests PRICE PER MAIL PIECE MI Marketplace Option - Phase 1 1.022.S.1 MI Marketplace Option - Phase 2 1.022.S.2 Second Price Year Price (12 months) $ $ Price per completed HRA $ Price per incomplete HRA above 5 minutes a) Fixed price for monthly call volumes up to 1,500, including all related sub-tasks b) Fixed price for monthly call volume at least 25% greater than 1,500, including all related sub-tasks c) Fixed price for monthly call volume at least 50% greater than 1,500, including all related sub-tasks d) Fixed price for monthly call volume at least 75% greater than 1,500, including all related sub-tasks e) Fixed price for monthly call volume at least 100% greater than 1,500, including all related sub-tasks Year Third Fourth Year Price Year Price Fifth Year Price a) $5,386,426 a) $5,386,426 a) $5,386,426 a) $5,386,426 a) $5,386,426 b) $5,988,842 b) $5,988,842 b) $5,988,842 b) $5,988,842 b) $5,988,842 c) $6,487,247 c) $6,487,247 c) $6,487,247 c) $6,487,247 c) $6,487,247 d) $7,085,614 d) $7,085,614 d) $7,085,614 d) $7,085,614 d) $7,085,614 e) $7,651,521 e) $7,651,521 e) $7,651,521 e) $7,651,521 e) $7,651,521 f) $8,094,239 f) $8,094,239 f) $8,094,239 f) $8,094,239 f) $8,094,239 g) $8,604,459 g) $8,604,459 g) $8,604,459 g) $8,604,459 g) $8,604,459 h) $9,262,562 h) $9,262,562 h) $9,262,562 h) $9,262,562 h) $9,262,562 i) $9,793,428 i) $9,793,428 i) $9,793,428 i) $9,793,428 i) $9,793,428 j) $10,423,271 j) $10,423,271 j) $10,423,271 j) $10,423,271 j) $10,423,271 k) $10,865,989 k) $10,865,989 k) $10,865,989 k) $10,865,989 k) $10,865,989 l) $12,663,849 l) $12,663,849 l) $12,663,849 l) $12,663,849 l) $12,663,849 m) $13,828,606 m) $13,828,606 m) $13,828,606 m) $13,828,606 m) $13,828,606 n) $15,242,083 n) $15,242,083 n) $15,242,083 n) $15,242,083 n) $15,242,083 o) $16,511,725 o) $16,511,725 o) $16,511,725 o) $16,511,725 o) $16,511,725 p) $18,013,833 p) $18,013,833 p) $18,013,833 p) $18,013,833 p) $18,013,833 q) $19,346,469 q) $19,346,469 q) $19,346,469 q) $19,346,469 q) $19,346,469 1.38 $ 1.38 $ 1.38 $ 1.38 $ 1.38 34.00 $ 34.00 $ 34.00 $ 34.00 $ 34.00 18.00 $ 18.00 $ 18.00 $ 18.00 $ 18.00 a) $541,173 a) $541,173 a) $541,173 a) $541,173 a) $541,173 b) $530,623 b) $530,623 b) $530,623 b) $530,623 b) $530,623 c) $541,173 c) $541,173 c) $541,173 c) $541,173 c) $541,173 d) $666,028 d) $666,028 d) $666,028 d) $666,028 d) $666,028 e) $676,578 e) $676,578 e) $676,578 e) $676,578 e) $676,578 MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Page 36 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Work Requirements Reference 1.022.T Method Fixed price for monthly call volume up to 70,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS UP TO 5.2 MINUTES PER CALL. Year Price (12 months) Fixed price for monthly call volume at least 20% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 40% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 60% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 80% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 100% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 120% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 140% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 160% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 180% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 200% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 220% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 240% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 260% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 280% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 300% greater than 70,000 including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Year Price Fourth Year Price Fifth Year Price $ 6,665,351 $ 6,665,351 $ 6,665,351 $ 6,665,351 $ 7,641,365 $ 7,641,365 $ 7,641,365 $ 7,641,365 $ 8,617,379 $ 8,617,379 $ 8,617,379 $ 8,617,379 $ 9,593,394 $ 9,593,394 $ 9,593,394 $ 9,593,394 $ 10,569,408 $ 10,569,408 $ 10,569,408 $ 10,569,408 $ 11,545,422 $ 11,545,422 $ 11,545,422 $ 11,545,422 $ 12,521,436 $ 12,521,436 $ 12,521,436 $ 12,521,436 $ 13,497,450 $ 13,497,450 $ 13,497,450 $ 13,497,450 $ 14,473,464 $ 14,473,464 $ 14,473,464 $ 14,473,464 $ 15,449,479 $ 15,449,479 $ 15,449,479 $ 15,449,479 $ 16,425,493 $ 16,425,493 $ 16,425,493 $ 16,425,493 $ 17,401,507 $ 17,401,507 $ 17,401,507 $ 17,401,507 $ 18,377,521 $ 18,377,521 $ 18,377,521 $ 18,377,521 $ 19,353,535 $ 19,353,535 $ 19,353,535 $ 19,353,535 $ 20,329,549 $ 20,329,549 $ 20,329,549 $ 20,329,549 $ 21,305,564 $ 21,305,564 $ 21,305,564 $ 21,305,564 Page 37 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Work Requirements Reference 1.022.T Method Fixed price for monthly call volume up to 70,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 5.3 AND 8.0 MINUTES PER CALL. Year Price (12 months) Fixed price for monthly call volume at least 20% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 40% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 60% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 80% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 100% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 120% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 140% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 160% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 180% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 200% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 220% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 240% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 260% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 280% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 300% greater than 70,000 including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Year Price Fourth Year Price Fifth Year Price $ 9,293,082 $ 9,293,082 $ 9,293,082 $ 9,293,082 $ 10,794,642 $ 10,794,642 $ 10,794,642 $ 10,794,642 $ 12,296,202 $ 12,296,202 $ 12,296,202 $ 12,296,202 $ 13,797,762 $ 13,797,762 $ 13,797,762 $ 13,797,762 $ 15,299,323 $ 15,299,323 $ 15,299,323 $ 15,299,323 $ 16,800,883 $ 16,800,883 $ 16,800,883 $ 16,800,883 $ 18,302,443 $ 18,302,443 $ 18,302,443 $ 18,302,443 $ 19,804,003 $ 19,804,003 $ 19,804,003 $ 19,804,003 $ 21,305,564 $ 21,305,564 $ 21,305,564 $ 21,305,564 $ 22,807,124 $ 22,807,124 $ 22,807,124 $ 22,807,124 $ 24,308,684 $ 24,308,684 $ 24,308,684 $ 24,308,684 $ 25,810,244 $ 25,810,244 $ 25,810,244 $ 25,810,244 $ 27,311,805 $ 27,311,805 $ 27,311,805 $ 27,311,805 $ 28,813,365 $ 28,813,365 $ 28,813,365 $ 28,813,365 $ 30,314,925 $ 30,314,925 $ 30,314,925 $ 30,314,925 $ 31,816,485 $ 31,816,485 $ 31,816,485 $ 31,816,485 Page 38 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Work Requirements Reference 1.022.T Method Fixed price for monthly call volume up to 70,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 8.1 AND 11.0 MINUTES PER CALL. Year Price (12 months) Fixed price for monthly call volume at least 20% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 40% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 60% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 80% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 100% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 120% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 140% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 160% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 180% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 200% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 220% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 240% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 260% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 280% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 300% greater than 70,000 including all related sub-tasks MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Year Price Fourth Year Price Fifth Year Price $ 12,108,507 $ 12,108,507 $ 12,108,507 $ 12,108,507 $ 14,173,152 $ 14,173,152 $ 14,173,152 $ 14,173,152 $ 16,237,798 $ 16,237,798 $ 16,237,798 $ 16,237,798 $ 18,302,443 $ 18,302,443 $ 18,302,443 $ 18,302,443 $ 20,367,088 $ 20,367,088 $ 20,367,088 $ 20,367,088 $ 22,431,734 $ 22,431,734 $ 22,431,734 $ 22,431,734 $ 24,496,379 $ 24,496,379 $ 24,496,379 $ 24,496,379 $ 26,561,024 $ 26,561,024 $ 26,561,024 $ 26,561,024 $ 28,625,670 $ 28,625,670 $ 28,625,670 $ 28,625,670 $ 30,690,315 $ 30,690,315 $ 30,690,315 $ 30,690,315 $ 32,754,960 $ 32,754,960 $ 32,754,960 $ 32,754,960 $ 34,819,606 $ 34,819,606 $ 34,819,606 $ 34,819,606 $ 36,884,251 $ 36,884,251 $ 36,884,251 $ 36,884,251 $ 38,948,896 $ 38,948,896 $ 38,948,896 $ 38,948,896 $ 41,013,542 $ 41,013,542 $ 41,013,542 $ 41,013,542 $ 43,078,187 $ 43,078,187 $ 43,078,187 $ 43,078,187 Page 39 MAXIMUS Attachment A DTMB Contract No. 071B1300215 First Pricing Component Work Requirements Reference 1.022.T Method Fixed price for monthly call volume up to 70,000, including all related sub-tasks BASED ON AVERAGE CALL LENGTHS BETWEEN 11.1 AND 15.0 MINUTES PER CALL. Year Price (12 months) Fixed price for monthly call volume at least 20% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 40% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 60% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 80% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 100% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 120% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 140% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 160% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 180% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 200% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 220% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 240% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 260% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 280% greater than 70,000 including all related sub-tasks Fixed price for monthly call volume at least 300% greater than 70,000 including all related sub-tasks SMS/Text Messaging & Outbound Dialer 1.022.U Automated Outbound Calls PRICE PER CALL Fixed price for monthly automated SMS/Text Messaging Fixed Price per occurance - Category 1 SMS updates to existing campaign content Fixed Price per occurance - Category 2 SMS new campaign, single message Fixed Price per occurance - Category 3 SMS new campaign, multi-message workflow (polls, surveys) Fixed Price per occurance - Category 4 SMS custom reporting automations MAXIMUS HMP3 & WR Att A as of 10-2-19.xlsx Second Price Year Third Fourth Year Price Year Price Fifth Year Price $ 15,862,408 $ 15,862,408 $ 15,862,408 $ 15,862,408 $ 18,677,833 $ 18,677,833 $ 18,677,833 $ 18,677,833 $ 21,493,259 $ 21,493,259 $ 21,493,259 $ 21,493,259 $ 24,308,684 $ 24,308,684 $ 24,308,684 $ 24,308,684 $ 27,124,109 $ 27,124,109 $ 27,124,109 $ 27,124,109 $ 29,939,535 $ 29,939,535 $ 29,939,535 $ 29,939,535 $ 32,754,960 $ 32,754,960 $ 32,754,960 $ 32,754,960 $ 35,570,386 $ 35,570,386 $ 35,570,386 $ 35,570,386 $ 38,385,811 $ 38,385,811 $ 38,385,811 $ 38,385,811 $ 41,201,237 $ 41,201,237 $ 41,201,237 $ 41,201,237 $ 44,016,662 $ 44,016,662 $ 44,016,662 $ 44,016,662 $ 46,832,088 $ 46,832,088 $ 46,832,088 $ 46,832,088 $ 49,647,513 $ 49,647,513 $ 49,647,513 $ 49,647,513 $ 52,462,939 $ 52,462,939 $ 52,462,939 $ 52,462,939 $ 55,278,364 $ 55,278,364 $ 55,278,364 $ 55,278,364 $ 58,093,789 $ 58,093,789 $ 58,093,789 $ 58,093,789 $0.05 $0.05 $ 71,134 $ 71,134 $ 71,134 $ 71,134 $ 2,344 $ 2,344 $ 2,344 $ 2,344 $ 4,647 $ 4,647 $ 4,647 $ 4,647 $ 9,294 $ 9,294 $ 9,294 $ 9,294 $ 13,850 $ 13,850 $ 13,850 $ 13,850 $0.05 $0.05 Page 40