The methodology used to project each of the values reflected in columns a through f for all the components of lines 1 through 21 must be shown clearly in section C-1. For those lines that have multiple benefit service categories in the PBP, the substantiation must reflect a corresponding level of detail. No substantiation is necessary. Worksheet C1 is required just for Part B-only plans. Any justification provided should be in enough detail to fully explain the specific variation at issue.
Some justifications can be very brief.
For example, merely stating that an expected variation was needed to eliminate the costs in the worksheet for a previously offered benefit that is being dropped in the contract year would be adequate. Other justifications, such as one pertaining to the costs of a new benefit, need to be more detailed and must include all computations. Please categorize your justifications of expected value entries using the terms listed below, depending on whether the justification relates to direct medical or costs, administrative costs. Renegotiated provider agreement. Delete base period benefit.